TY - JOUR
T1 - Excess incidence of squamous cell esophageal cancer among US black men
T2 - Role of social class and other risk factors
AU - Brown, Linda Morris
AU - Hoover, Robert
AU - Silverman, Debra
AU - Baris, Dalsu
AU - Hayes, Richard
AU - Swanson, G. Marie
AU - Schoenberg, Janet
AU - Greenberg, Raymond
AU - Liff, Jonathan
AU - Schwartz, Ann
AU - Dosemeci, Mustafa
AU - Pottern, Linda
AU - Fraumeni, Joseph F.
PY - 2001/1/15
Y1 - 2001/1/15
N2 - 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.
AB - 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.
KW - Alcohol drinking
KW - Case-control studies
KW - Diet
KW - Esophageal neoplasms
KW - Racial stocks
KW - Risk factors
KW - Social class
KW - Tobacco
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U2 - 10.1093/aje/153.2.114
DO - 10.1093/aje/153.2.114
M3 - Article
C2 - 11159155
AN - SCOPUS:0035863438
SN - 0002-9262
VL - 153
SP - 114
EP - 122
JO - American Journal of Epidemiology
JF - American Journal of Epidemiology
IS - 2
ER -