Research & Service

The AACR 101st Annual Meeting 2010 took place Saturday, April 17, at the Walter E. Washington Convention Center in Washington, DC

Socioeconomic status plays a role in colorectal cancer mortality rates by hindering healthcare interventions from working or restricting patient access to care, according to the results of a retrospective cohort study by Columbia University’s Mailman School of Public Health. This finding, among others related to colorectal cancer outcomes, was presented at the American Association for Cancer Research (AACR) 101st Annual Meeting 2010 held in Washington D.C. on April 18th.  Andrew C. Wang, MPH ‘10, in the Department of Epidemiology at the Mailman School and first author was invited to present the paper, “Social Inequalities in Colorectal Cancer: Three Theories and the Impact of Diffusion, Healthcare, and Socioeconomic Status.”

“Those living in low socioeconomic status counties have yet to benefit from advances made in preventing colorectal cancer deaths over 30 years ago, whereas those living in high socioeconomic status counties have seen a 33 to 50 percent reduction in mortality,” said Wang. He and colleagues used administrative and U.S. census data from 2005 to pinpoint colon cancer mortality rates among whites and blacks from over 3,000 counties. Colorectal cancer is a major cause of mortality; according to the researchers, last year 16.2 people out of 100,000 died from the disease.

Theories

Experts believe that a few theories may help to explain why inequalities in colon cancer mortality rates exist. The first, fundamental cause theory, suggests inequalities exist because of unequal access to resources. A second one, diffusion of knowledge, is the theory that information is not equally distributed throughout hospitals and the population, thus the speed and slow uptake of new medical innovations may affect inequalities. The third, unequal services, suggests that inequality arises from lack of medical facilities within an area.

Decreased mortality from colorectal cancer was associated with access to healthcare, living in states with histories of quicker uptake of new information and adoption of technology, and living in a higher socioeconomic county. Most importantly, Wang said, socioeconomic status acted as a type of catalyst - access to healthcare and diffusion of knowledge made only a limited difference in low socioeconomic counties, but clearly lowered colorectal cancer mortality rates for high socioeconomic status counties.

“The findings indicated that all theories were supported, yet some had more impact than others,” noted Bruce G. Link, PhD, professor of epidemiology and sociomedical sciences at the Mailman School, and senior author. “While diffusion of innovation was extremely important, this was mostly the case for black males.” Healthcare professionals now face the challenge of ramping-up efforts to reduce colorectal cancer mortality rates among low-status individuals and those in low socioeconomic status areas, according to Wang. “The medical and non-medical community is not doing enough to prevent colorectal cancer,” he said. “Much more can be done for those who are disadvantaged.”

 AACR is the world's oldest and largest professional organization dedicated to advancing cancer research. The annual meeting attracts more than 17,000 participants who share the latest discoveries and developments in the field.