ATLANTA -- Disparities in colorectal cancer death rates take a large toll on the national economy, with poorer, less-educated communities bearing the greatest burden, according to data presented at the Eighth American Association for Cancer Research (AACR) Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, held Nov. 13-16.
"A substantial number of colorectal cancer deaths are potentially preventable through routine colorectal screening," said Hannah K. Weir, PhD, senior epidemiologist with the Centers for Disease Control and Prevention (CDC) in Atlanta. "We found that many of those preventable deaths are in lower socioeconomic status communities, and cancer puts a huge economic burden on those communities."
Eliminating avoidable colorectal cancer deaths would result in $4.2 billion in productivity gains in men and $2.2 billion in women, Weir said. Figures are nationwide, and based on a 3 percent discount rate, a measure of future value. They include wages and salaries, plus expected financial contributions to family care; they do not include the cost of diagnosis, treatment, and care, according to Weir. She said that increasing awareness of colorectal cancer in lower socioeconomic status (SES) areas could help decrease colorectal cancer deaths and the associated economic losses.
The researchers also determined that in lower SES communities, 194,927 years of potential life were lost due to premature colorectal cancer deaths, compared with 128,812 years of potential life lost in the higher SES communities. "Those are years in which these people would have been contributing to the financial welfare of their family and their community," Weir said.
Weir based her study on U.S. mortality and population data from 2008 to 2012, focusing on the number of colorectal cancer deaths of Americans between 50 and 74 years of age. She and her fellow researchers defined higher SES areas as those areas where at least 85 percent of the population had graduated from high school; all other areas were considered lower SES areas.
Weir applied the colorectal cancer mortality rate from higher SES communities to lower SES communities and found that 16.8 percent of the deaths in lower SES areas were potentially preventable if the mortality rate had been equal to that of the higher SES areas.
In the past few decades, disparities in colorectal cancer deaths have reversed, Weir said. The disease once disproportionately affected white patients, and those with higher socioeconomic status. As screening methods and awareness increased, the gap narrowed, then in recent years, reversed itself.
"Higher SES groups have better access to care, and have fewer barriers including being unable to take time off work," she explained.
Weir said that her findings indicate that eliminating educational disparities in lower SES areas could help decrease colorectal cancer deaths and stem the productivity lost from those deaths.
Weir said one limitation of the study is that some states did not designate Hispanic status of their residents, so data on Hispanic communities may be incomplete.
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The study was run by the CDC, and Weir declares no conflicts of interest.
To interview Hannah Weir, contact Julia Gunther at julia.gunther@aacr.org or 215-446-6896.
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Abstract: A89
Title: Estimating potential years of life lost and productivity lost due to avoidable premature colorectal cancer deaths in US counties with lower educational attainment
Authors: Hannah K. Weir, Chunyu Li, Jane Henley, Djenaba Joseph. Centers for Disease Control and Prevention, Atlanta, GA.
Background: Measures of socioeconomic status (SES) are inversely associated with colorectal cancer (CRC) mortality. This study aims to estimate potential years of life lost and productivity lost due to premature cancer deaths among United States residents of lower SES areas, as measured by percentage of high school graduates.
Methods: 2008-2012 mortality and population data were used to estimate the number of expected CRC deaths between the ages of 50-74 years by applying the mortality rate from higher SES areas (?85% high school graduation) to lower SES areas, by race/ethnicity, age, and gender. Excess deaths (observed minus expected deaths) were used to estimate the years of potential life lost (YPLL) and the human capital method was used to estimate productivity lost due to YPLL.
Results: Risk of CRC deaths was inversely associated with SES among non-Hispanic whites, non-Hispanic blacks and Hispanics. Of the 85,484 CRC deaths during 2008-2012 in lower SES groups, 16.8% (n=14,398) were potentially preventable if the CRC mortality rates in all areas were the same as higher SES areas. Eliminating avoidable CRC deaths would result in $4.2 billion in productivity gains in men and $2.2 billion in women based on a 3% discount rate.
Conclusion: A substantial number of CRC deaths are potentially preventable through routine colorectal screening. SES disparities represent a large number of these deaths and result in a large economic burden in lower SES areas. Eliminating educational disparities could help decrease CRC cancer deaths and associated productivity lost in the US. These estimates do not include the costs to diagnose, treat and care for CRC patients.