Cancer Mortality Rates Vary by Education Level

According to the results of a study published in the Journal of the National Cancer Institute, a lower level of education is linked with an increased risk of cancer death among African-American and White men and women.

Many health outcomes—including overall risk of death—are known to vary by race and socioeconomic status. Relatively few studies, however, have assessed how race and socioeconomic status interact to influence cancer incidence and mortality in the U.S.

To evaluate the effect of education on cancer mortality among African-American and White men and women, researchers collected information from death certificates and the U.S. Bureau of the Census for the year 2001. Information was collected about residents of 47 states and Washington, D.C.

The study included 111,376,196 individuals between the ages of 25 and 64. This population experienced 137,708 cancer deaths during 2001.

Among both White and African-American men, overall risk of cancer death was more than twice as high among those with 12 or fewer years of education compared with those with more than 12 years of education.
African-American women with 12 or fewer years of education were 43% more likely to die of cancer than African-American women with more than 12 years of education.
White women with 12 or fewer years of education were 76% more likely to die of cancer than White women with more than 12 years of education.
In addition to overall risk of cancer death, the risks of death from four specific types of cancer (lung, breast, colorectal, and prostate) were also higher among less educated people than among more educated people. The finding that breast cancer mortality is higher among less educated women than among more educated women is different than what has been reported previously but was observed among both African-American and White women.
The researchers conclude that cancer death rates vary considerably by level of education, with a higher rate of death among those with the least education. Because the study was restricted to African Americans and Whites between the ages of 25 and 64, these results may not be applicable to other racial groups or to older individuals.

Reference: Albano JD, Ward E, Jemal A et al. Cancer mortality in the United States by education level and race. Journal of the National Cancer Institute. 2007;99:1384-94.

Pain Still Occurs in Majority of Cancer Patients

According to an article recently published in Annals of Oncology, over half of patients diagnosed with cancer experience pain, despite guidelines that have been adopted for the reduction of pain. Patients diagnosed with advanced or terminal cancer experience an even higher rate of pain, with those diagnosed with head and neck cancer experiencing the most pain.

Pain is one of the most feared consequences associated with the diagnosis of cancer. As cancer becomes more advanced, it grows and spreads throughout the body. This growth crowds organs, tissues, vasculature (veins, arteries, or capillaries), lymph nodes (part of the immune system), and/or bones. The cancerous growth itself can cause pain as it places pressure on nerves and it can interfere with normal biological processes, causing a blockage and/or buildup of fluid or other components.

Pain has been recognized as an important focus of treatment among cancer patients. Guidelines have been established by healthcare panels for the treatment of pain, depending upon severity and other existing medical conditions of the patient. Often, patients with terminal cancer remain on pain medications throughout the duration of treatment once their disease has become advanced. In fact, controlling pain is one of the top priorities in end-of-life patient care. However, data regarding the prevalence of pain among patients with cancer remain limited.

Researchers from the Netherlands recently conducted a clinical study to review data regarding the prevalence of pain among cancer patients. The data included a literature review regarding pain in different disease stages and different types of cancer. Fifty-two studies were included in this analysis.

33% of patients who had undergone curative therapy for their cancer reported pain following therapy.

59% of patients undergoing treatment for cancer reported pain.

64% of patients with advanced, metastatic, or terminal cancer reported pain.

Patients diagnosed with head and neck cancer reported the greatest incidence of pain.
Over half of all patients diagnosed with cancer reported overall pain, with more than one-third grading their pain as moderate or severe.
The researchers concluded that, despite guidelines to control pain in cancer patients, “cancer pain still is a major problem.” Patients diagnosed with cancer who are experiencing pain should speak with their healthcare provider regarding the prevention or control of pain.

Reference: van den Beuken-van Everdingen MHJ, de Rijke J, Kessels A, et al. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Annals of Oncology. 2007; 18; 1437-1449.