American Journal of Epidemiology Vol. 153, No. 2 : 114-122
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Excess Incidence of Squamous Cell Esophageal Cancer among US Black Men: Role of Social Class and Other Risk Factors
1 Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD.
2 Cancer Center, Michigan State University, East Lansing, MI.
3 New Jersey State Department of Health, Trenton, NJ.
4 Medical University of South Carolina, Charleston, SC.
5 Rollins School of Public Health, Emory University, Atlanta, GA.
6 Epidemiology Department, Karmanos Cancer Institute, Detroit, MI.
7 Women's Health Initiative, National Heart, Lung, and Blood Institute, Bethesda, MD.
Data from a population-based case-control study were used to evaluate the relation between social class factors and squamous cell esophageal cancer and the extent to which alcohol, tobacco, diet, and low income contribute to the higher incidence among Black men than among White men in the United States. A total of 347 male cases (119 White, 228 Black) and 1,354 male controls (743 White, 611 Black) were selected from three US geographic areas (Atlanta, Georgia, Detroit, Michigan, and New Jersey). Cases were residents of the study areas aged 30–79 years who had been diagnosed with histologically confirmed esophageal cancer between 1986 and 1989. The adjusted odds ratios for subjects with annual incomes less than $10,000 versus incomes of $25,000 or more were 4.3 (95% confidence interval: 2.1, 8.7) for Whites and 8.0 (95% confidence interval: 4.3, 15.0) for Blacks. The combination of all four major risk factors—low income, moderate/heavy alcohol intake, tobacco use, and infrequent consumption of raw fruits and vegetables—accounted for almost all of the squamous cell esophageal cancers in Whites (98%) and Blacks (99%) and for 99% of the excess incidence among Black men. Thus, lifestyle modifications, especially a lowered intake of alcoholic beverages, would markedly decrease the incidence of squamous cell esophageal cancer in both racial groups and would narrow the racial disparity in risk. Further studies on the determinants of social class may help to identify a new set of exposures for this tumor that are amenable to intervention.
alcohol drinking; case-control studies; diet; esophageal neoplasms; racial stocks; risk factors; social class; tobacco
Abbreviations: CI, confidence interval; OR, odds ratio; PAR, population attributable risk; SOC, Standard Occupational Classification
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M Santibanez, J Vioque, J Alguacil, X Barber, M Garcia de la Hera, T Kauppinen, and for the PANESOES Study Group Occupational exposures and risk of oesophageal cancer by histological type: a case-control study in eastern Spain Occup. Environ. Med., November 1, 2008; 65(11): 774 - 781. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Kamangar, M. M. Schantz, C. C. Abnet, R. B. Fagundes, and S. M. Dawsey High Levels of Carcinogenic Polycyclic Aromatic Hydrocarbons in Mate Drinks Cancer Epidemiol. Biomarkers Prev., May 1, 2008; 17(5): 1262 - 1268. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. P. POLEDNAK SECULAR TREND IN U.S. BLACK-WHITE DISPARITIES IN SELECTED ALCOHOL-RELATED CANCER INCIDENCE RATES Alcohol Alcohol., March 1, 2007; 42(2): 125 - 130. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Kamangar, G. M. Dores, and W. F. Anderson Patterns of Cancer Incidence, Mortality, and Prevalence Across Five Continents: Defining Priorities to Reduce Cancer Disparities in Different Geographic Regions of the World J. Clin. Oncol., May 10, 2006; 24(14): 2137 - 2150. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Jansson, A. L.V. Johansson, O. Nyren, and J. Lagergren Socioeconomic Factors and Risk of Esophageal Adenocarcinoma: A Nationwide Swedish Case-Control Study Cancer Epidemiol. Biomarkers Prev., July 1, 2005; 14(7): 1754 - 1761. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. P. POLEDNAK RECENT TRENDS IN INCIDENCE RATES FOR SELECTED ALCOHOL-RELATED CANCERS IN THE UNITED STATES Alcohol Alcohol., May 1, 2005; 40(3): 234 - 238. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. C. Enzinger and R. J. Mayer Esophageal Cancer N. Engl. J. Med., December 4, 2003; 349(23): 2241 - 2252. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Pickens and M. B. Orringer Geographical distribution and racial disparity in esophageal cancer Ann. Thorac. Surg., October 1, 2003; 76(4): S1367 - 1369. [Full Text] [PDF]
|
|
|
|
 |
|
 G. E. Fryer Jr, L. A. Green, S. M. Dovey, B. P. Yawn, R. L. Phillips, and D. Lanier Variation in the Ecology of Medical Care Ann. Fam. Med, July 1, 2003; 1(2): 81 - 89. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. T. Mayne and S. A. Navarro Diet, Obesity and Reflux in the Etiology of Adenocarcinomas of the Esophagus and Gastric Cardia in Humans J. Nutr., November 1, 2002; 132(11): 3467S - 3470. [Abstract] [Full Text] [PDF]
|
|