Abstract
BackgroundTobacco and low socioeconomic status have been acknowledged as potential risk factors for upper aero-digestive tract (UADT) cancers in North America. In context of reducing adult male smoking prevalence (by over 50%), in the past few decades in Canada, this study tried to document changes in smoking-attributable UADT cancer mortality rates, among Canadian males of different social strata, between 1986 and 2001.MethodsThe contribution of smoking to UADT cancer mortality was estimated indirectly by using lung cancer mortality as an indicator of the accumulated mortality from smoking in a population. This method was applied to UADT cancer death rates of 35–69 year old socially stratified males. Data, stratified by neighborhood income quintile, could be obtained from Statistics Canada, for four census years, 1986, 1991, 1996, and 2001.ResultsA total of 2704 male deaths were analyzed. Between 1986 and 2001, UADT cancer deaths reduced by 30% (32 to 22 per 100,000) but the proportion of these deaths attributable to smoking reduced much more, by 41% (22 to 13 per 100,000). In the span of fifteen years, absolute social inequality (measured by rate difference between the highest and the lowest stratum) in smoking-attributable male UADT cancer mortality in Canada reduced by 47% and relative social inequality (measured by rate ratios) reduced by 9%.ConclusionThe present analyses reveal that between 1986 and 2001, smoking-attributable UADT cancer mortality rates among adult males (35–69 years) in Canada reduced in all social strata and the social inequalities in these rates have narrowed. Analysis of more current data will be of interest to confirm these trends.
Highlights
Tobacco and low socioeconomic status have been acknowledged as potential risk factors for upper aero-digestive tract (UADT) cancers in North America
Between 1986 and 2001, overall UADT cancer death rates fell by 30% (32 to 22 per 100,000) and the death rates attributable to smoking fell by 41% (22 to 13 per 100,000)
By 2001, UADT cancer deaths fell by 37% (56 to 36 per 100,000) and smoking-attributable proportions fell by 42% (43 to 25 per 100,000) in the lowest stratum
Summary
Tobacco and low socioeconomic status have been acknowledged as potential risk factors for upper aero-digestive tract (UADT) cancers in North America. The prevalence of smoking in adult males has decreased by over fifty percent in the past few decades in highincome countries, including Canada and the US [15], but most of these countries have observed the greatest declines among higher social strata [16,17]. Concern arises if these declines in smoking prevalence have similar or different effects on smoking-attributable mortality rates for males of different social strata [17]. The aim of this paper is to describe changes in smokingattributable UADT cancer mortality among Canadian males of different social strata between 1986 and 2001
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