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. 2008 Jul 16;100(14):1003–1012. doi: 10.1093/jnci/djn207

Table 1.

Trends in age-adjusted rates* of death from four major cancers by educational attainment, ages 25–64 years, 43 states and the District of Columbia, 1993-2001

White non-Hispanic Black non-Hispanic
1993 Rate 2001 Rate APC P value§ 1993 Rate 2001 Rate APC P value§
Lung and bronchus
    Male
        All education 46.9 (48.8) 35.7 (36.4) −3.3 (−3.5) <.001 (<.001) 81.4 (88.5) 57.9 (60.2) −4.0 (−4.4) <.001 (<.001)
            <12 y 88.1 87.3 −0.1 .905 98.3 90.4 −0.2 .705
            12 y 59.5 53.2 −1.5 .001 98.6 73.7 −3.2 .009
            13–15 y 32.7 24.2 −3.5 <.001 45.6 32.2 −4.7 <.001
            ≥16 y 20.7 13.7 −4.9 <.001 38.3 21.0 −6.8 <.001
        Rate difference 67.3 73.6 60.0 69.4
        Rate ratio 4.2 (4.1 to 4.4) 6.4 (6.2 to 6.6) <.001 2.6 (2.5 to 2.8) 4.3 (3.9 to 4.8) <.001
        Ptrend# .001 .004
    Female
        All education† 27.6 (28.4) 24.7 (25.1) −1.4 (−1.6) <.001 (<.001) 28.7 (30.5) 26.3 (26.9) −1.0 (−1.5) .068 (.011)
            <12 y 45.5 55.4 2.4 <.001 32.7 30.4 0.8 .476
            12 y 32.1 33.1 0.1 .657 37.3 35.7 −0.7 .191
            13–15 y 19.8 16.6 −1.7 .003 20.1 19.3 −1.3 .282
            ≥16 y 13.9 11.6 −2.9 <.001 14.8 16.7 −2.2 .246
        Rate difference‖ 31.6 43.8 17.9 13.7
        Rate ratio 3.3 (3.1 to 3.5) 4.8 (4.5 to 5.0) <.001 2.2 (1.8 to 2.7) 1.8 (1.6 to 2.1) .090
        Ptrend# .009 .059
Colon and rectum
    Male
        All education† 11.7 (12.0) 10.6 (10.7) −1.5 (−1.6) <.001 (<.001) 18.0 (19.7) 17.9 (18.3) 0.0 (−0.7) .981 (.080)
            <12 y 14.1 16.0 0.9 .237 17.4 20.9 2.7 <.001
            12 y 14.6 13.9 −0.9 .130 21.9 23.9 1.0 .341
            13–15 y 9.2 8.1 −1.1 .006 15.4 11.7 −2.7 .161
            ≥16 y 9.3 7.9 −2.4 <.001 16.3 11.5 −4.8 .011
        Rate difference‖ 4.8 8.2 1.1 9.4
        Rate ratio 1.5 (1.4 to 1.6) 2.0 (1.9 to 2.2) <.001 1.1 (0.9 to 1.3) 1.8 (1.5 to 2.2) <.001
        Ptrend# .039 .010
    Female
        All education† 8.3 (8.5) 7.2 (7.3) −1.7 (−1.8) <.001 (<.001) 13.0 (13.7) 13.0 (13.3) −0.3 (−0.7) .518 (.103)
            < 12 y 9.5 10.4 1.4 .073 11.0 10.3 −0.3 .745
            12 y 9.7 9.2 −1.0 .010 16.1 17.8 −0.3 .730
            13–15 y 6.4 5.5 −1.6 .006 9.4 10.0 0.7 .659
            ≥16 y 6.8 5.4 −3.0 <.001 15.6 12.2 −2.6 .030
        Rate difference‖ 2.8 4.9 −4.5 −1.9
        Rate ratio 1.4 (1.3 to 1.6) 1.9 (1.7 to 2.1) <.001 0.7 (0.6 to 0.9) 0.8 (0.7 to 1.0) .232
        Ptrend# .063 .288
Breast
    Female
        All education† 27.4 (28.2) 21.4 (21.7) −3.4 (−3.5) <.001 (<.001) 38.0 (40.1) 34.9 (35.5) −1.1 (1.5) .027 (.003)
            <12 y 27.4 24.1 −1.4 .029 30.0 28.7 0.1 .855
            12 y 30.6 25.4 −2.9 <.001 45.3 43.4 −1.5 .078
            13–15 y 23.2 17.3 −3.6 <.001 35.3 30.0 −0.9 .447
            ≥16 y 27.4 20.1 −4.3 <.001 45.7 35.8 −3.8 <.001
        Rate difference‖ 0.0 4.0 −15.7 −7.0
        Rate ratio 1.0 (1.0 to 1.1) 1.2 (1.1 to 1.3) <.001 0.7 (0.6 to 0.7) 0.8 (0.7 to 0.9) .004
        Ptrend# .025 .046
Prostate
    Male
        All education† 3.9 (4.0) 2.7 (2.8) −4.6 (−4.7) <.001 (<.001) 11.8 (12.7) 8.8 (9.1) −3.3 (−3.6) <.001 (<.001)
            <12 y 4.0 3.4 −1.6 .054 10.4 9.6 −1.6 .133
            12 y 4.3 3.3 −3.5 .003 16.2 12.7 −1.6 .171
            13–15 y 3.4 2.3 −5.5 <.001 10.3 5.3 −7.4 .003
            ≥16 y 3.8 2.3 −6.3 <.001 7.6 4.8 −5.9 .071
        Rate difference‖ 0.2 1.1 2.7 4.8
        Rate ratio 1.1 (0.9 to 1.2) 1.5 (1.3 to 1.7) .001 1.4 (1.0 to 1.8) 2.0 (1.5 to 2.7) .054
        Ptrend# .022 .211
*

Single-year rates per 100 000 people were age adjusted to the 2000 US standard population for ages 25–64 years.

Excludes persons with missing data for educational attainment (data in parentheses includes persons with missing educational attainment).

Annual percent change (APC) estimated from weighted least squares linear regression models fit to the log-transformed age-adjusted death rates for years 1993–2001.

§

Value adjacent to APC indicates test for APC statistical difference from 0, two-sided. Value adjacent to rate ratios indicates test for statistical difference between rate ratios for single years 1993 and 2001.

The difference between the age-adjusted rates for less than 12 years and 16 or more years education for the indicated year.

Rate ratio (95% confidence interval) comparing age-adjusted rate for less than 12 years education to 16 or more years education for the indicated year.

#

Test for trend in APC over levels of education using inverse variance weighted linear regression.