Persons with lower socioeconomic status (SES) have disproportionately higher cancer death rates than those with higher SES, regardless of demographic factors such as race/ethnicity. For example, cancer mortality rates among both African American and non-Hispanic white men with 12 or fewer years of education are almost 3 times higher than those of college graduates for all cancers combined, and 4-5 times higher for lung cancer. Furthermore, progress in reducing cancer death rates has been slower in persons with lower SES. These disparities occur largely because persons with lower SES are at higher risk for cancer and have less favorable outcomes after diagnosis.
In addition to poverty and social discrimination, cancer occurrence in a population may also be influenced by cultural and/or inherited factors that decrease or increase risk. For example, Hispanic women have a lower risk of breast cancer probably in part because they tend to begin having children at a younger age, which decreases breast cancer risk. Individuals who maintain a primarily plant-based diet or do not use tobacco because of cultural or religious beliefs have a lower risk of many cancers. Higher rates of cancers related to infectious agents (e.g., stomach, liver, uterine cervix) in populations that include a large number of recent immigrants, such as Hispanics and Asians, may reflect a higher prevalence of infection in the country of origin. Genetic factors may also explain some differences in cancer incidence.
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