Abstract
BackgroundLittle is known about the role of economic recessions in the risk of cancer. Therefore, we evaluated the impact of the severe economic recession in Finland from 1991–1994 on the incidence of all cancers and cancer subtypes among a middle-age and older population.MethodsFrom the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD), a population-based sample of 1,620 women and men aged 53–73 years were examined from 1998–2001. The cancer-free participants completed a questionnaire on the possible impact of the 1990s recession in Finland on their lives. Incident cases of cancer were obtained through record linkage with the Finnish Cancer Registry. Cox proportional hazards regression was used to estimate hazard ratios (HR) of incident cancer events after adjusting for possible confounders.ResultsA total of 1,096 cancer-free participants had experienced socioeconomic hardships due to the recession at the baseline. During 20 years of follow-up, 473 participants developed cancer. After adjustment for age, baseline socioeconomic position, and lifestyle factors, the risk of all cancers was 32% higher among men who experienced socioeconomic hardships compared to those who did not (HR 1.32; 95% confidence interval [CI], 1.00–1.74, P = 0.05). Prostate-genital cancer was 71% higher among men with hardships (n = 103, HR 1.71; 95% CI, 1.06–2.74, P = 0.02). No association was observed between socioeconomic hardships and subsequent risk of total or any subtype of cancer among women.ConclusionThe 1990s economic recession was associated with increased risk of all cancers, especially prostate-genital cancer among Finnish middle-age and older men, but no association with cancer was observed in women.
Highlights
Cancer is the second leading cause of death worldwide.[1]
After adjustment for age, the risk of any cancer was 20% higher among participants, who experienced socioeconomic hardships compared to those who did not (HR 1.20; 95% confidence interval [CI], 1.00–1.50, P = 0.07)
The increased risk of any type of cancer was observed only among men who had experienced socioeconomic hardships (HR 1.28; 95% CI, 1.00–1.69, P = 0.08 for model 1 and hazard ratios (HR) 1.32; 95% CI, 1.00–1.74, P = 0.05 for model 2)
Summary
Cancer is the second leading cause of death worldwide.[1]. Several biological and environmental risk factors of cancer have been identified. Socioeconomic position (SEP) and the change of SEP across the life-course are likely to influence cancer risk factors, associating with cancer incidence and mortality.[2] Economic recessions often change the SEP in part of the population,[3] causing various social and financial disadvantages, which are termed as socioeconomic hardships.[4]. Most of the previous studies on recessions and health have investigated the physical and mental health only among those who have become unemployed during recessions.[5,6] The global financial crisis in 2008, awakened the scientific community to the possible effects that recessions may have on cancer. We evaluated the impact of the severe economic recession in Finland from 1991–1994 on the incidence of all cancers and cancer subtypes among a middleage and older population
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