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Socioeconomic Disparities in Gastric Cancer and Identification of a Single SES Variable for Predicting Risk

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Abstract

Introduction

Socioeconomic status (SES) is a known risk factor for gastric cancer (GC). This study seeks to examine education, income, and occupation variables separately to identify the single variable that can be best used to assess SES risk for GC.

Methods

Data from a case-control survey study were used. Logistic regression models were created for education, income, and occupation adjusted for age, sex, and race. Models were compared using AIC, c-statistics, and pseudo-R square to determine the model that had the highest risk predictive ability.

Results

GC cases had lower education levels and more commonly held jobs in unskilled labor. Annual household income was lower in cases compared to controls. Age, gender, race, education, and occupation were associated with increased risk of GC. The education model adjusted for age, gender, and race found < high school (HS) education to have an OR of 3.18 (95% CI 1.09–9.25) for GC compared to > HS education. The occupation model demonstrated that employment in unskilled labor had OR of 4.32 (95% CI 1.05–17.76) for GC compared to professional occupation. Model fit was best for the education model (AIC: 113.583, lower AIC is better) compared to income (117.562) or occupation (117.032). Education contributed the most to model variability (% delta pseudo-R square (4.7%)) compared to occupation (4.0%) or income (3.8%).

Conclusion

Education level was the single most reliable measure of GC risk among 3 SES variables and can be employed as an ideal single indicator of SES-related GC risk when multiple SES factors cannot be obtained.

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Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

Research reported in this publication was supported by UG1CA189823 (Alliance for Clinical Trials in Oncology NCORP Grant). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA

    Srawani Sarkar, Marc J. Dauer & Haejin In

  2. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA

    Haejin In

Authors
  1. Srawani Sarkar
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  2. Marc J. Dauer
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  3. Haejin In
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Contributions

Srawani Sarkar: Writing, original draft; review and editing; visualization, validation. Marc J. Dauer: Writing, original draft preparation. Haejin In: Conceptualization; formal analysis; supervision; writing, review and editing.

Corresponding author

Correspondence to Haejin In.

Ethics declarations

The study was approved by Albert Einstein College of Medicine IRB (IRB# 2015-4763). Consent to participate: Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Available from the corresponding author on reasonable request.

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Appendix

Appendix

Table 5 Descriptive statistics of family history, BMI, smoking, and alcohol intake
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Table 6 Comparisons of model fit with different variable to represent SES (models including family history, BMI, smoking, and alcohol intake)
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Table 7 Relative contribution of SES variables to the explanatory power of the model, including family history, BMI, smoking and alcohol intake
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Table 8 Multivariable model comparisons using different variables to represent SES (family history, BMI, smoking, and alcohol intake also included in models)
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Sarkar, S., Dauer, M.J. & In, H. Socioeconomic Disparities in Gastric Cancer and Identification of a Single SES Variable for Predicting Risk. J Gastrointest Canc 53, 170–178 (2022). https://doi.org/10.1007/s12029-020-00564-z

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  • DOI: https://doi.org/10.1007/s12029-020-00564-z

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