Table 3. Relative Risk (RR) of Total Incident Cancer and of Site-Specific Cancer by Educational Attainment in Women.
| Educational Attainment | p-trend a | |||||||
| Less than High School | Completed High School | Post High School Training | Some College | College Graduate | Post Graduate | |||
| All Cancer | ||||||||
| Cases, No. | 1228 | 4837 | 1983 | 4676 | 2781 | 2862 | ||
| Age Adjusted Rate b | 1321.06 | 1300.76 | 1311.88 | 1358.01 | 1378.40 | 1394.23 | ||
| Age Adjusted RR(95%CI) | 0.93(0.87,0.99) | 0.93(0.89,0.97) | 0.94(0.89,0.99) | 0.97(0.93,1.02) | 0.99(0.94,1.04) | 1.00 | 0.001 | |
| Age, Smoking Adjusted RR(95%CI) | 0.86(0.80,0.92) | 0.89(0.85,0.93) | 0.89(0.84,0.94) | 0.91(0.87,0.96) | 0.96(0.91,1.02) | 1.00 | <0.001 | |
| Multivariate Adjusted RR(95%CI) c | 0.84(0.79,0.90) | 0.88(0.84,0.92) | 0.88(0.83,0.93) | 0.91(0.87,0.95) | 0.96(0.92,1.02) | 1.00 | <0.001 | |
| Smoking Related Cancer d | ||||||||
| Cases, No. | 326 | 1017 | 401 | 947 | 452 | 403 | ||
| Age Adjusted Rate b | 353.27 | 270.30 | 264.98 | 276.22 | 229.34 | 201.12 | ||
| Age Adjusted RR(95%CI) | 1.66(1.43,1.92) | 1.35(1.20,1.51) | 1.32(1.15,1.51) | 1.38(1.23,1.55) | 1.13(0.99,1.30) | 1.00 | <0.001 | |
| Age, Smoking Adjusted RR(95%CI) | 1.18(1.02,1.37) | 1.10(0.98,1.23) | 1.03(0.90,1.19) | 1.07(0.95,1.20) | 1.02(0.89,1.17) | 1.00 | 0.013 | |
| Multivariate Adjusted RR(95%CI) | 1.19(1.02,1.38) | 1.10(0.98,1.24) | 1.05(0.91,1.20) | 1.07(0.96,1.21) | 1.02(0.89,1.17) | 1.00 | 0.012 | |
| Head and Neck Cancer | ||||||||
| Cases, No. | 22 | 83 | 35 | 71 | 35 | 30 | ||
| Age Adjusted Rate b | 26.47 | 22.14 | 23.14 | 20.55 | 17.31 | 13.87 | ||
| Age Adjusted RR(95%CI) | 1.61(0.92,2.79) | 1.54(1.01,2.34) | 1.59(0.97,2.59) | 1.41(0.92,2.16) | 1.18(0.73,1.93) | 1.00 | 0.024 | |
| Age, Smoking Adjusted RR(95%CI) | 1.08(0.62,1.87) | 1.21(0.79,1.83) | 1.20(0.74,1.96) | 1.07(0.70,1.64) | 1.05(0.65,1.71) | 1.00 | 0.505 | |
| Multivariate Adjusted RR(95%CI) | 1.21(0.69,2.13) | 1.33(0.87,2.03) | 1.33(0.81,2.17) | 1.13(0.74,1.73) | 1.07(0.66,1.74) | 1.00 | 0.22 | |
| Stomach Cancer | ||||||||
| Cases, No. | 12 | 48 | 16 | 33 | 15 | 20 | ||
| Age Adjusted Rate b | 10.95 | 12.67 | 10.58 | 9.73 | 7.40 | 10.71 | ||
| Age Adjusted RR(95%CI) | 1.13(0.55,2.31) | 1.21(0.72,2.04) | 1.02(0.53,1.97) | 0.95(0.54,1.65) | 0.76(0.39,1.48) | 1.00 | 0.281 | |
| Age, Smoking Adjusted RR(95%CI) | 1.05(0.51,2.16) | 1.18(0.70,1.99) | 1.00(0.52,1.94) | 0.91(0.52,1.58) | 0.75(0.38,1.46) | 1.00 | 0.372 | |
| Multivariate Adjusted RR(95%CI) | 0.92(0.44,1.92) | 1.14(0.67,1.94) | 1.00(0.52,1.94) | 0.90(0.52,1.58) | 0.75(0.39,1.47) | 1.00 | 0.622 | |
| Colon Cancer e | ||||||||
| Cases, No. | 113 | 363 | 164 | 325 | 178 | 139 | ||
| Age Adjusted Rate b | 114.73 | 95.73 | 108.15 | 95.68 | 90.69 | 71.20 | ||
| Age Adjusted RR(95%CI) | 1.60(1.24,2.05) | 1.35(1.11,1.65) | 1.54(1.22,1.93) | 1.36(1.11,1.66) | 1.29(1.04,1.61) | 1.00 | <0.001 | |
| Age, Smoking Adjusted RR(95%CI) | 1.56(1.21,2.00) | 1.34(1.10,1.63) | 1.50(1.20,1.89) | 1.32(1.08,1.61) | 1.28(1.03,1.60) | 1.00 | 0.001 | |
| Multivariate Adjusted RR(95%CI) | 1.37(1.06,1.77) | 1.24(1.01,1.51) | 1.44(1.14,1.80) | 1.28(1.05,1.57) | 1.26(1.01,1.58) | 1.00 | 0.029 | |
| Rectum Cancer | ||||||||
| Cases, No. | 34 | 127 | 56 | 116 | 67 | 61 | ||
| Age Adjusted Rate b | 34.84 | 33.81 | 37.06 | 33.67 | 34.40 | 30.11 | ||
| Age Adjusted RR(95%CI) | 1.16(0.76,1.77) | 1.12(0.82,1.52) | 1.22(0.85,1.76) | 1.12(0.82,1.53) | 1.11(0.79,1.57) | 1.00 | 0.447 | |
| Age, Smoking Adjusted RR(95%CI) | 1.09(0.72,1.67) | 1.09(0.80,1.48) | 1.18(0.82,1.71) | 1.08(0.79,1.48) | 1.10(0.78,1.56) | 1.00 | 0.657 | |
| Multivariate Adjusted RR(95%CI) | 1.05(0.68,1.62) | 1.06(0.78,1.45) | 1.17(0.81,1.69) | 1.08(0.79,1.47) | 1.10(0.77,1.55) | 1.00 | 0.822 | |
| Pancreatic Cancer | ||||||||
| Cases, No. | 26 | 97 | 44 | 100 | 52 | 61 | ||
| Age Adjusted Rate b | 26.15 | 25.31 | 29.01 | 29.34 | 26.73 | 29.85 | ||
| Age Adjusted RR(95%CI) | 0.84(0.53,1.34) | 0.83(0.60,1.14) | 0.94(0.64,1.39) | 0.95(0.69,1.31) | 0.86(0.60,1.25) | 1.00 | 0.375 | |
| Age, Smoking Adjusted RR(95%CI) | 0.76(0.48,1.20) | 0.78(0.57,1.08) | 0.88(0.60,1.30) | 0.88(0.64,1.22) | 0.84(0.58,1.21) | 1.00 | 0.168 | |
| Multivariate Adjusted RR(95%CI) | 0.74(0.47,1.19) | 0.79(0.57,1.09) | 0.88(0.60,1.30) | 0.89(0.64,1.22) | 0.84(0.58,1.21) | 1.00 | 0.171 | |
| Lung Cancer | ||||||||
| Cases, No. | 245 | 687 | 265 | 651 | 298 | 237 | ||
| Age Adjusted Rate b | 262.84 | 183.39 | 175.24 | 189.69 | 151.23 | 119.69 | ||
| Age Adjusted RR(95%CI) | 2.14(1.79,2.56) | 1.55(1.34,1.80) | 1.49(1.25,1.77) | 1.62(1.39,1.87) | 1.27(1.07,1.51) | 1.00 | <0.001 | |
| Age, Smoking Adjusted RR(95%CI) | 1.43(1.20,1.71) | 1.22(1.05,1.41) | 1.11(0.93,1.32) | 1.19(1.03,1.38) | 1.12(0.94,1.33) | 1.00 | <0.001 | |
| Multivariate Adjusted RR(95%CI) | 1.43(1.19,1.72) | 1.22(1.05,1.42) | 1.12(0.94,1.33) | 1.20(1.03,1.39) | 1.12(0.94,1.33) | 1.00 | <0.001 | |
| Melanomas of the Skin | ||||||||
| Cases, No. | 25 | 201 | 79 | 200 | 150 | 168 | ||
| Age Adjusted Rate b | 26.13 | 54.02 | 52.23 | 57.91 | 73.65 | 81.66 | ||
| Age Adjusted RR(95%CI) | 0.33(0.22,0.51) | 0.67(0.55,0.82) | 0.64(0.49,0.84) | 0.71(0.58,0.88) | 0.91(0.73,1.13) | 1.00 | <0.001 | |
| Age, Smoking Adjusted RR(95%CI) | 0.34(0.23,0.53) | 0.69(0.56,0.85) | 0.66(0.50,0.86) | 0.73(0.59,0.89) | 0.92(0.73,1.14) | 1.00 | <0.001 | |
| Multivariate Adjusted RR(95%CI) | 0.40(0.26,0.62) | 0.71(0.57,0.87) | 0.67(0.51,0.88) | 0.74(0.60,0.91) | 0.93(0.74,1.15) | 1.00 | <0.001 | |
| Bladder Cancer | ||||||||
| Cases, No. | 26 | 130 | 47 | 110 | 55 | 60 | ||
| Age Adjusted Rate b | 27.64 | 34.25 | 30.97 | 32.28 | 27.91 | 30.08 | ||
| Age Adjusted RR(95%CI) | 0.85(0.54,1.35) | 1.12(0.83,1.53) | 1.02(0.70,1.49) | 1.07(0.78,1.46) | 0.93(0.64,1.33) | 1.00 | 0.886 | |
| Age, Smoking Adjusted RR(95%CI) | 0.69(0.43,1.10) | 1(0.73,1.36) | 0.87(0.59,1.28) | 0.90(0.65,1.23) | 0.86(0.60,1.24) | 1.00 | 0.404 | |
| Multivariate Adjusted RR(95%CI) | 0.67(0.42,1.07) | 0.98(0.72,1.34) | 0.86(0.59,1.27) | 0.89(0.65,1.23) | 0.87(0.60,1.25) | 1.00 | 0.306 | |
| Kidney Cancer | ||||||||
| Cases, No. | 41 | 98 | 39 | 93 | 36 | 52 | ||
| Age Adjusted Rate b | 41.70 | 26.22 | 25.95 | 27.20 | 17.41 | 25.78 | ||
| Age Adjusted RR(95%CI) | 1.68(1.12,2.54) | 1.03(0.73,1.44) | 1.01(0.67,1.53) | 1.06(0.75,1.49) | 0.70(0.46,1.07) | 1.00 | 0.006 | |
| Age, Smoking Adjusted RR(95%CI) | 1.61(1.07,2.44) | 1.01(0.72,1.42) | 0.98(0.65,1.49) | 1.02(0.72,1.43) | 0.69(0.45,1.06) | 1.00 | 0.011 | |
| Multivariate Adjusted RR(95%CI) | 1.29(0.85,1.98) | 0.89(0.63,1.25) | 0.87(0.58,1.33) | 0.95(0.67,1.33) | 0.69(0.45,1.06) | 1.00 | 0.179 | |
| Thyroid Cancer | ||||||||
| Cases, No. | 11 | 62 | 15 | 50 | 30 | 25 | ||
| Age Adjusted Rate b | 11.86 | 16.81 | 9.80 | 14.38 | 14.43 | 11.87 | ||
| Age Adjusted RR(95%CI) | 1.03(0.51,2.10) | 1.44(0.90,2.29) | 0.84(0.44,1.59) | 1.21(0.75,1.96) | 1.22(0.72,2.08) | 1.00 | 0.542 | |
| Age, Smoking Adjusted RR(95%CI) | 1.07(0.52,2.18) | 1.50(0.94,2.39) | 0.87(0.46,1.66) | 1.24(0.77,2.01) | 1.24(0.73,2.11) | 1.00 | 0.435 | |
| Multivariate Adjusted RR(95%CI) | 1.01(0.49,2.08) | 1.45(0.90,2.33) | 0.86(0.45,1.63) | 1.23(0.76,1.99) | 1.26(0.74,2.14) | 1.00 | 0.609 | |
| Lymphoma | ||||||||
| Cases, No. | 64 | 236 | 87 | 213 | 121 | 128 | ||
| Age Adjusted Rate b | 71.15 | 61.72 | 57.25 | 62.25 | 61.34 | 62.77 | ||
| Age Adjusted RR(95%CI) | 1.04(0.77,1.40) | 0.99(0.80,1.23) | 0.91(0.69,1.19) | 0.98(0.79,1.22) | 0.96(0.75,1.23) | 1.00 | 0.855 | |
| Age, Smoking Adjusted RR(95%CI) | 1.01(0.75,1.37) | 0.98(0.79,1.21) | 0.90(0.68,1.18) | 0.97(0.78,1.21) | 0.95(0.74,1.22) | 1.00 | 0.988 | |
| Multivariate Adjusted RR(95%CI) | 0.99(0.72,1.34) | 0.94(0.76,1.18) | 0.88(0.67,1.15) | 0.96(0.77,1.20) | 0.95(0.74,1.22) | 1.00 | 0.772 | |
| Leukemia | ||||||||
| Cases, No. | 24 | 77 | 38 | 68 | 31 | 40 | ||
| Age Adjusted Rate b | 22.06 | 20.60 | 25.12 | 19.73 | 15.66 | 19.75 | 0.162 | |
| Age Adjusted RR(95%CI) | 1.27(0.76,2.11) | 1.04(0.71,1.53) | 1.27(0.82,1.99) | 1.01(0.68,1.49) | 0.79(0.49,1.26) | 1.00 | 0.169 | |
| Age, Smoking Adjusted RR(95%CI) | 1.27(0.76,2.11) | 1.04(0.71,1.53) | 1.26(0.81,1.97) | 1.00(0.67,1.47) | 0.78(0.49,1.25) | 1.00 | 0.401 | |
| Multivariate Adjusted RR(95%CI) | 1.14(0.68,1.93) | 0.97(0.66,1.43) | 1.19(0.76,1.85) | 0.96(0.65,1.42) | 0.78(0.49,1.26) | 1.00 | ||
| Invasive Breast Cancer e | ||||||||
| Cases, No. | 202 | 876 | 372 | 924 | 574 | 626 | ||
| Age Adjusted Rate b | 332.68 | 383.29 | 400.06 | 434.73 | 462.79 | 482.76 | ||
| Age Adjusted RR(95%CI) | 0.72(0.61,0.84) | 0.79(0.71,0.87) | 0.81(0.72,0.93) | 0.88(0.80,0.98) | 0.93(0.83,1.04) | 1.00 | <0.001 | |
| Age, Smoking Adjusted RR(95%CI) | 0.70(0.60,0.82) | 0.78(0.70,0.86) | 0.80(0.71,0.91) | 0.87(0.78,0.96) | 0.93(0.83,1.04) | 1.00 | <0.001 | |
| Multivariate Adjusted RR(95%CI) | 0.83(0.70,0.98) | 0.87(0.78,0.97) | 0.88(0.77,1.00) | 0.93(0.84,1.04) | 0.98(0.87,1.10) | 1.00 | 0.002 | |
| Cervical Cancer | ||||||||
| Cases, No. | 11 | 32 | 11 | 30 | 13 | 15 | ||
| Age Adjusted Rate b | 13.96 | 8.91 | 7.36 | 8.51 | 6.51 | 7.19 | ||
| Age Adjusted RR(95%CI) | 1.85(0.84,4.04) | 1.29(0.70,2.40) | 1.05(0.48,2.30) | 1.23(0.66,2.29) | 0.89(0.42,1.87) | 1.00 | 0.083 | |
| Age, Smoking Adjusted RR(95%CI) | 1.63(0.74,3.57) | 1.19(0.64,2.21) | 0.95(0.44,2.08) | 1.12(0.60,2.09) | 0.85(0.41,1.79) | 1.00 | 0.163 | |
| Multivariate Adjusted RR(95%CI) | 1.20(0.52,2.74) | 0.95(0.49,1.83) | 0.86(0.39,1.93) | 1.04(0.54,1.98) | 0.82(0.38,1.75) | 1.00 | 0.646 | |
| Endometrial Cancer f | ||||||||
| Cases, No. | 65 | 307 | 117 | 285 | 194 | 215 | ||
| Age Adjusted Rate b | 72.72 | 82.71 | 77.52 | 82.55 | 94.16 | 103.78 | ||
| Age Adjusted RR(95%CI) | 0.67(0.51,0.89) | 0.80(0.67,0.96) | 0.75(0.60,0.93) | 0.79(0.66,0.95) | 0.92(0.76,1.11) | 1.00 | 0.001 | |
| Age, Smoking Adjusted RR(95%CI) | 0.72(0.54,0.95) | 0.83(0.69,0.98) | 0.77(0.62,0.97) | 0.82(0.69,0.98) | 0.93(0.77,1.13) | 1.00 | 0.003 | |
| Multivariate Adjusted RR(95%CI) | 0.65(0.49,0.87) | 0.77(0.65,0.93) | 0.75(0.60,0.95) | 0.85(0.71,1.02) | 0.99(0.82,1.21) | 1.00 | <0.001 | |
| Ovarian Cancer e , g | ||||||||
| Cases, No. | 32 | 123 | 53 | 125 | 98 | 73 | ||
| Age Adjusted Rate b | 37.19 | 32.72 | 35.14 | 36.07 | 48.77 | 35.08 | ||
| Age Adjusted RR(95%CI) | 0.96(0.64,1.46) | 0.94(0.70,1.25) | 0.99(0.69,1.41) | 1.02(0.77,1.36) | 1.36(1.01,1.85) | 1.00 | 0.175 | |
| Age, Smoking Adjusted RR(95%CI) | 0.98(0.65,1.49) | 0.94(0.70,1.26) | 1.00(0.70,1.42) | 1.03(0.77,1.38) | 1.37(1.01,1.86) | 1.00 | 0.202 | |
| Multivariate Adjusted RR(95%CI) | 1.08(0.70,1.67) | 1.00(0.74,1.36) | 1.07(0.75,1.54) | 1.11(0.83,1.49) | 1.43(1.05,1.94) | 1.00 | 0.476 | |
Abbreviations: RR, relative risk; CI, confidence interval; BMI, body mass index (calculated as weight kilograms divided by height in meters squared); MHT, menopausal hormone therapy.
a
p for trend across education groups.
b
Age-adjusted Incidence rates are per 100,000 person-years by 5 year age intervals.
c
Multivariate models included the following covariates: age (yrs); race (White, Black, Hispanic and Asian, Pacific Islanders and Native Americans, combined); smoking (Never, Quit < = 1 pack per day, Quit>1 pack per day, Currently smoking < = 1 pack per day, Currently Smoking>1 pack per day); alcohol consumptions g/day (0; 0.1−<5, 5 −<15, 15<30, 30+); energy (Kcal/day);BMI (<25, 25−<30, 30−<35, 35+); Physical activity (Frequency of at least 20 minutes that caused increases in breathing or heart rate, or worked up a sweat: Never/Rarely, 1–3 time per month, 1–2 times per week, 3–4 times per week, 5+ times per week, Unknown), married (yes/no); family history of cancer (yes/no); MHT use (Current, Former, Never). In female specific anatomical sites, a combined variable of age at first birth and number of children was included.
d
Smoking related cancers include sites: head neck, esophageal, lung, pancreas, bladder.
e
For the sites of colon, breast and ovarian models were adjusted for screening behavior.
f
Women who reported a hysterectomy were excluded from the statistical models for endometrial cancer.
g
Women with both ovaries removed were excluded from the statistical models for ovarian cancer.