A new report, published in part by the American Cancer Society, has revealed that certain types of cancers are strongly associated with living in poverty while others are associated with being wealthy.
The study included information from over 3 million cancer diagnoses, using poverty rates as the indicator of socioeconomic status (SES) in an effort to identify any links between the two factors. Each diagnosis was organized by type of cancer and by the poverty level of the area the patient lived in. Out of 46 cancer sites tested, 38 of them showed a significant relationship with poverty, whether that meant being more likely or less likely to have that type of cancer as a result of low SES. The cancers most strongly associated with high levels of poverty were found to be those of the larynx, cervix and Kaposi sarcoma, which affects connective tissues.
Conversely, wealthier patients are most significantly associated with melanoma and thyroid cancers. Why might certain cancers disproportionately affect the poor?
There are obvious ways in which poverty could impact health — the impoverished are more likely to lack access to health care and are less likely to have stable food security. However, there also appear to be impacts that are less noticeable and require more examination, as this study has revealed. The answer may lie in “behavioral risk factors” that occur more often in communities with high levels of poverty, such as “tobacco, alcohol and intravenous drug use, sexual transmission and poor diet.”
For the types of cancers that affect wealthier communities more often, the study finds these cancers are the ones most likely to be over-diagnosed. It seems that lacking access to adequate health care and certain behavioral factors together predispose those in poverty to have different kinds of cancers. What is most unfortunate is that the cancers associated with low levels of poverty, the study found, tend to be the most lethal.
A relationship does exist between SES and cancer, and this study is one of the first to use poverty levels to find this link. In one of the first studies ever done on the subject, published in the same journal as this newest report and using a different measure of SES, researchers said, “It is increasingly apparent that a substantial proportion of the disparities in cancer defined by race and ethnicity can be attributed to socioeconomic status.”
Unfortunately, this relationship is often hard to define and there are not extensive amounts of literature on the topic. However, interest in finding the links between cancer and poverty is growing, and the results of this report reaffirm the importance of taking SES into account. Hopefully more researchers will make similar efforts to examine the details of the relationship between poverty and health, including the unfortunate link between poverty and lethal types of cancer.