Devesa S S, Diamond E L
J Natl Cancer Inst. 1980 Sep;65(3):515-28.
Data from the 1969-71 Third National Cancer Survey were used to study the association of cancer incidence with income and education as indicated by census tract of residence. Also considered was the effect of adjustment for differences in socioeconomic distribution on the observed excess risk of cervial cancer and lower risk of breast cancer among black women compared to white women. Strong positive associations with both income and education were found, with the rates based on 19,344 breast cancer cases among white women. These observations were noted in most geographic areas studied. The relative risk showed little apparent relationship to age. The rates based on 1,570 cases among black women indicated a strong positive association with education but not with income. Socioeconomic adjustment reduced by almost one-half the black-white difference in breast cancer rates, and education had a stronger effect than did income. White women continued to have a significantly higher rate after such adjustment. Conversely, the incidence of cancer of the cervix showed strong negative associations with each of the two variables among both the 3,802 cases in white women and 954 cases in black women. The negative gradient decreased with age and was apparent in almost all the areas. The excess risk among black women was reduced by two-thirds with socioeconomic adjustment, though the rates remained significantly different. Income had a stronger association than did education with cervical cancer incidence.
1969 - 1971年第三次全国癌症调查的数据被用于研究癌症发病率与收入及教育程度之间的关联,这些数据通过居住的普查区来体现。同时还考虑了社会经济分布差异的调整对观察到的黑人女性与白人女性相比宫颈癌风险过高及乳腺癌风险较低这一情况的影响。在对19344例白人女性乳腺癌病例的数据进行分析时,发现收入和教育程度都与之呈强正相关。在大多数研究的地理区域都观察到了这些现象。相对风险与年龄之间几乎没有明显关系。基于1570例黑人女性病例的数据表明,教育程度与之呈强正相关,但收入并非如此。社会经济调整使乳腺癌发病率的黑白差异降低了近一半,且教育程度的影响比收入更强。经过这样的调整后,白人女性的发病率仍然显著更高。相反,在3802例白人女性宫颈癌病例和954例黑人女性宫颈癌病例中,宫颈癌发病率与这两个变量均呈强负相关。这种负梯度随年龄降低,且在几乎所有地区都很明显。经过社会经济调整后,黑人女性的过高风险降低了三分之二,尽管发病率仍然存在显著差异。与教育程度相比,收入与宫颈癌发病率的关联更强。