Area Socioeconomic Status and Early Onset Rectal Cancer in a Comprehensive Cancer Center: Evidence from Wisconsin

Lauren Giurini, PhD; Cibele Barbosa Carroll MD, PhD; Thomas Lawler, PhD; Jennifer M. Weiss, MD; Noelle K. LoConte, MD; Shaneda Warren Andersen, PhD

WMJ. 2025;124(5):416-420.

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ABSTRACT

Introduction: The incidence of early-onset rectal cancer has increased over the past 3 decades and the causes are unknown. Neighborhood socioeconomic status, a measure of social and economic characteristics in a given area, may be associated with early-onset rectal cancer through environments that affect diet, exercise, and health care utilization. We investigated the association between neighborhood-level socioeconomic status and age at rectal cancer diagnosis in Wisconsin.

Methods: We utilized data on 172 rectal cancer patients from the Carbone Cancer Center rectal cancer registry. We measured neighborhood socioeconomic status using the Area Deprivation Index, derived from 17 census measures of education, employment, income, and housing, standardized at the state and national levels. Linear and logistic regression models were employed to estimate the association between the Area Deprivation Index and age at diagnosis.

Results: Of the 172 cases of rectal cancer, 47 (27%) were considered early-onset (<50 years). Null associations were observed between the Area Deprivation Index and age at diagnosis using the national- and state-standardized index. Moreover, estimates using the nationally standardized index suggested lower odds of early-onset rectal cancer in lower socioeconomic status neighborhoods (OR_Q5 = 0.11, 95% CI, 0.01–1.89).

Conclusions: This study initiates research investigating the association between area-level socioeconomic status and early-onset rectal cancer. While we find no association between the Area Deprivation Index and early-onset rectal cancer, we posit these findings are due to the characteristics of our sample. Future studies are needed to comprehensively explore associations between social factors and early rectal cancer outcomes.

Author affiliations: University of Wisconsin Carbone Cancer Center, Madison, Wisconsin (Giurini, Carroll, Lawler, Weiss, LoConte, Andersen); Department of Population Health Sciences, University of Wisconsin (UW) School of Medicine and Public Health, Madison, Wisconsin (Giurini, Andersen); Department of Medicine, UW School of Medicine and Public Health, Madison, Wisconsin (Weiss, LoConte).
Corresponding author: Shaneda Warren Andersen, PhD, WARF Office Building, Ste 1007B, 610 Walnut St, Madison, WI 53726; phone 608.265.8257; email snandersen@wisc.edu; ORCID ID 0000-0001-7581-7224
Financial disclosures: None declared.
Funding/support: This research was conducted with support from the Center of Demography of Health and Aging at the University of Wisconsin-Madison’s training grant from the National Institute on Aging at the National Institutes of Health (training grant T32 AG000129-30 to LG); the National Cancer Institute at the National Institutes of Health (grant number R01 CA255318 to SWA); the University of Wisconsin—Madison, Office of Vice Chancellor for Research and Graduate Education with funding from the Wisconsin Alumni Research Foundation; the University of Wisconsin-Madison’s Carbone Cancer Center (grant number P30 CA014520).
Acknowledgement: This 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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