Education and risk of cancer in a large cohort of men and women in the United States.

Background: Education inequalities in cancer incidence have long been noted. It is not clear, however, whether such inequalities persist in the United States, especially for less common malignancies and after adjustment for individual risk factors.

Methodology/principal Findings: Within the NIH-AARP Diet and Health Study, we examined the association between education and the risk of developing cancers in a prospective cohort of 498,455 participants who were 50-71 year old and without cancer at enrollment in 1995/96. During a maximum 8.2 years of follow-up we identified 40,443 cancers in men and 18,367 in women. In age-adjusted models, the least educated men (
Conclusions/significance: We found a higher risk of malignant disease, particularly smoking- related cancers, among those in the lowest educational attainment category. Only some of the educational gradient is attributable to smoking. The persistence of substantial education inequalities in cancer incidence poses a challenge for etiologic research and public health policy.