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. 2017 Jan;26(1):75-84.
doi: 10.1158/1055-9965.EPI-16-0371. Epub 2016 Sep 21.

Baby Boomers and Birth Certificates: Early-Life Socioeconomic Status and Cancer Risk in Adulthood

Antoinette M Stroup  1   2   3 , Kimberly A Herget  4 , Heidi A Hanson  5   6 , Diana Lane Reed  5 , Jared T Butler  7 , Kevin A Henry  7   8   9 , C Janna Harrell  4 , Carol Sweeney  4   5   10 , Ken R Smith  5   11
Affiliations

Baby Boomers and Birth Certificates: Early-Life Socioeconomic Status and Cancer Risk in Adulthood

Antoinette M Stroup et al. Cancer Epidemiol Biomarkers Prev. 2017 Jan.

Abstract

Background: Early-life socioeconomic status (SES) may play a role in cancer risk in adulthood. However, measuring SES retrospectively presents challenges. Parental occupation on the birth certificate is a novel method of ascertaining early-life SES that has not been applied in cancer epidemiology.

Methods: For a Baby-Boom cohort born from 1945-1959 in two Utah counties, individual-level Nam-Powers SES (Np-SES) was derived from parental industry/occupation reported on birth certificates. Neighborhood SES was estimated from average household income of census tract at birth. Cancer incidence was determined by linkage to Utah Cancer Registry records through the Utah Population Database. Hazard ratios (HR) for cancer risk by SES quartile were estimated using Cox proportional hazards regression.

Results: Females with low Np-SES at birth had lower risk of breast cancer compared with those in the highest Np-SES group [HRQ1/Q4 = 0.83; 95% confidence interval (CI), 0.72-0.97; HRQ2/Q4 = 0.81; 95% CI, 0.69-0.96]. Np-SES was inversely associated with melanoma (HRQ1/Q4 = 0.81; 95% CI, 0.67-0.98) and prostate cancer (HRQ1/Q4 = 0.70; 95% CI, 0.56-0.88). Women born into lower SES neighborhoods had significantly increased risk for invasive cervical cancer (HRQ1/Q4 = 1.44; 95% CI, 1.12-1.85; HRQ2/Q4 = 1.33; 95% CI, 1.04-1.72). Neighborhood SES had similar effects for melanoma and prostate cancers, but was not associated with female breast cancer. We found no association with SES for pancreas, lung, and colon and rectal cancers.

Conclusions: Individual SES derived from parental occupation at birth was associated with altered risk for several cancer sites.

Impact: This novel methodology can contribute to improved understanding of the role of early-life SES on cancer risk. Cancer Epidemiol Biomarkers Prev; 26(1); 75-84. ©2016 AACR.

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Conflict of interest statement

There are no conflicts of interest for authors on this paper.

Figures

Figure 1
Figure 1
Cumulative Incidence in Baby-Boom Cohort 1940–1959 by cancer site and Nam-Powers SES (Np-SES): (a) Female Breast Cancer (log rank p<0.05), (b) Invasive Cervical Cancer (log rank p<0.001), (c) Melanoma (log rank p<0.05), and (d) Prostate Cancer (log rank p<0.01)
Figure 1
Figure 1
Cumulative Incidence in Baby-Boom Cohort 1940–1959 by cancer site and Nam-Powers SES (Np-SES): (a) Female Breast Cancer (log rank p<0.05), (b) Invasive Cervical Cancer (log rank p<0.001), (c) Melanoma (log rank p<0.05), and (d) Prostate Cancer (log rank p<0.01)
Figure 1
Figure 1
Cumulative Incidence in Baby-Boom Cohort 1940–1959 by cancer site and Nam-Powers SES (Np-SES): (a) Female Breast Cancer (log rank p<0.05), (b) Invasive Cervical Cancer (log rank p<0.001), (c) Melanoma (log rank p<0.05), and (d) Prostate Cancer (log rank p<0.01)
Figure 1
Figure 1
Cumulative Incidence in Baby-Boom Cohort 1940–1959 by cancer site and Nam-Powers SES (Np-SES): (a) Female Breast Cancer (log rank p<0.05), (b) Invasive Cervical Cancer (log rank p<0.001), (c) Melanoma (log rank p<0.05), and (d) Prostate Cancer (log rank p<0.01)
Figure 2
Figure 2
Cumulative Incidence in Baby-Boom Cohort 1940–1959 by cancer site and 1960 census tract SES (BiCT-SES): (a) Female Breast Cancer (log rank p<0.01), (b) Invasive Cervical Cancer (log rank p<0.01), (c) Melanoma (log rank p<0.01), and (d) Prostate Cancer (log rank p<0.05)
Figure 2
Figure 2
Cumulative Incidence in Baby-Boom Cohort 1940–1959 by cancer site and 1960 census tract SES (BiCT-SES): (a) Female Breast Cancer (log rank p<0.01), (b) Invasive Cervical Cancer (log rank p<0.01), (c) Melanoma (log rank p<0.01), and (d) Prostate Cancer (log rank p<0.05)
Figure 2
Figure 2
Cumulative Incidence in Baby-Boom Cohort 1940–1959 by cancer site and 1960 census tract SES (BiCT-SES): (a) Female Breast Cancer (log rank p<0.01), (b) Invasive Cervical Cancer (log rank p<0.01), (c) Melanoma (log rank p<0.01), and (d) Prostate Cancer (log rank p<0.05)
Figure 2
Figure 2
Cumulative Incidence in Baby-Boom Cohort 1940–1959 by cancer site and 1960 census tract SES (BiCT-SES): (a) Female Breast Cancer (log rank p<0.01), (b) Invasive Cervical Cancer (log rank p<0.01), (c) Melanoma (log rank p<0.01), and (d) Prostate Cancer (log rank p<0.05)
Figure 3
Figure 3
Hazard Ratios and 95% Confidential Intervals for cancer in adulthood by cancer site and quartile of individual-level SES at birth (Np-SES), controlling for birth weight (pounds), year of birth, sibling in cohort, and gender (if applicable).
Figure 4
Figure 4
Hazard Ratios and 95% Confidential Intervals for cancer in adulthood by cancer site and quartile of neighborhood SES at birth (BiCT-SES), controlling for birth weight (pounds), year of birth, sibling in cohort, and gender (if applicable).
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