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. 2022 Jul 22:10:873805.
doi: 10.3389/fpubh.2022.873805. eCollection 2022.

Association Between Cancer Prevalence and Different Socioeconomic Strata in the US: The National Health and Nutrition Examination Survey, 1999-2018

Mingsi Wang  1 , Yang Liu  2 , Yi Ma  1 , Yue Li  1 , Chengyao Sun  1 , Yi Cheng  1 , Pengxin Cheng  1 , Guoxiang Liu  1 , Xin Zhang  1
Affiliations

Association Between Cancer Prevalence and Different Socioeconomic Strata in the US: The National Health and Nutrition Examination Survey, 1999-2018

Mingsi Wang et al. Front Public Health. .

Abstract

Background: Inequality in health outcomes in relation to Americans' socioeconomic status (SES) is rising. American Cancer Society depicts that the most common cancers are diagnosed in men and women in 2021. We aim to study socioeconomic inequalities in related cancers to investigate whether the cancer prevalence differs within the family income to poverty ratio (PIR).

Methods: The study investigated data from adults aged 20-85 years participated in the 1999-2018 National Health and Nutrition Examination Survey (NHANES) who had complete data available on PIR and cancer or malignancy information (n = 49,720). Participants were stratified into 3 categories of PIR: high income (PIR ≥ 4), middle income (>1 and <4), or at or below the federal poverty level (≤1).

Results: The prevalence of prostate cancer was higher in the middle-income (3.61% [n = 464]) and high-income groups (3.36% [n = 227]) than in the low-income group (1.83% [n = 84], all p < 0.001). The prevalence of breast cancer was higher in middle-income (2.86% [n = 390]) and high-income participants (3.48% [n = 218]) than in low-income participants (2.00% [n = 117], all p < 0.001). Compared with the low-income group in men (0.48% [n = 22]), a higher prevalence of colon and rectum cancer occurs in the middle-income (0.87% [n = 112], p = 0.012) and high-income groups (0.89% [n = 58], p = 0.018). The prevalence of lung cancer in women was lower in high-income participants than middle-income participants (0.10% [n = 6] vs. 0.29% [n = 39], p = 0.014).

Conclusions: Increasing disparities in cancer prevalence were identified across all socioeconomic categories analyzed in this study. To ensure the sustainable development goals, it is a global health priority to understand inequalities in health and to target interventions accordingly.

Keywords: NHANES; PIR; cancer; prevalence; socioeconomic strata.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Ten leading cancer types for the estimated new cancer cases by sex, United States, 2021.
Figure 2
Figure 2
Flow chart of the study population. Describes how the present sample of participants was composed. NHANES, National Health and Nutrition Examination Survey.
Figure 3
Figure 3
Overall prevalence of cancer among men participants 20 years or older stratified by income group, 1999–2018. Significant at p < 0.0167 after Bonferroni correction. (A) Prevalence of prostate cancer. (B) Prevalence of lung cancer. (C) Prevalence of colon and rectum cancer.
Figure 4
Figure 4
Overall prevalence of cancer among women participants 20 years or older stratified by income group, 1999–2018. Significant at p < 0.0167 after Bonferroni correction. (A) Prevalence of breast cancer. (B) Prevalence of lung cancer. (C) Prevalence of colon and rectum cancer.
Figure 5
Figure 5
Comparison of prevalence of men in 1999–2008 vs. 2009–2018, stratified by income group. (A) Prostate cancer. (B) Lung cancer. (C) Colon and rectum cancer.
Figure 6
Figure 6
Comparison of prevalence of women in 1999–2008 vs. 2009–2018, stratified by income group. (A) Breast cancer. (B) Lung cancer. (C) Colon and rectum cancer.
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