We know that being poor can make you sick. New research provides more evidence of this dismal link specifically for cancer: Living in poverty, it seems, is associated with a higher risk of contracting the kind of tumors that will kill you.
That's the conclusion of scientists who've investigated almost 3 million malignant tumors diagnosed in 16 states as well as the Los Angeles area – what they assert is the "most comprehensive assessment of the relationship between SES (socioeconomic status) and cancer incidence for the United States." Overall, they found no correlation between how poor or rich you are and how likely you are to get cancer. But drilling down into the census tracts with higher poverty rates, they noticed a prevalence of cancers with low incidence and high mortality rates. Wealthier neighborhoods were marked by cancers of high incidence, but low mortality rates. As the lead researcher, Francis Boscoe at the New York State Cancer Registry, explains: "When it comes to cancer, the poor are more likely to die of the disease while the affluent are more likely to die with the disease."
Out of 39 types of cancer, 14 showed a positive association with poverty, the researchers said in their study (which was partly supported by the Centers for Disease Control and Prevention). Poor neighborhoods were more likely to see cancers of the larynx, cervix, liver, and penis, as well as Kaposi sarcoma. They were also tied to an uptick in cancers related to tobacco use and human papillomavirus. Richer areas, meanwhile, suffered more from melanoma and other skin afflictions, and cancers of the thyroid and testes.
What's to account for these differences? Though race might play a part in the grand scheme of cancer, it's not applicable to what the researchers measured in this experiment. "The SES effects we report are independent of race, as race was adjusted for in the analysis," they say. Rather, there could be behavioral and economic things at play here, such as substance use and access to medical care, according to the study:
In general, cancer sites associated with behavioral risk factors such as tobacco, alcohol and intravenous drug use, sexual transmission, and poor diet tend to be associated with higher poverty. In contrast, cancer sites associated with overdiagnosis are associated with lower poverty, notably skin, thyroid, and prostate. Overdiagnosis refers to the clinical detection of asymptomatic tumors, often through advanced medical technology, that would otherwise remain undetected and uncounted.
For a breakdown of the cancers that are diagnosed in poor and rich neighborhoods, have a look at this graph the researchers made for four poverty levels using data from the 2005-2009 American Community Survey. The afflictions that strike in higher-poverty areas are located toward the right, and cancers discovered more in richer 'hoods are shown toward left: