Abstract
BackgroundIn many developed countries, socioeconomic status is associated with cancer incidence and survival. However, research in Japan is sparse. We examined the association between neighborhood deprivation based on the Japanese Deprivation Index and the risk of incidence, mortality and survival from total and major cancers in the Japan Public Health Center-based Prospective Study.Methods86,112 participants were followed through the end of 2009. A total of 10,416 incident cases and 5,510 deaths from cancer were identified among 1,348,437 person-years of follow-up (mean follow-up: 15.7 years). The Japanese deprivation index was used to access neighborhood deprivation. Hazard ratios and 95% confidence intervals were calculated by Cox regression analysis.ResultsWe found no associations between neighborhood deprivation index and the incidence of total and major cancers. In some cancer risks or deaths, however, we found positive or inverse associations with a higher deprivation index, such as a decreased risk of colorectal cancer incidence and an increased risk of liver cancer incidence and deaths in women.ConclusionAlthough some positive or inverse associations were detected for specific sites, the neighborhood deprivation index has no substantial overall association with the risk of incidence, mortality and survival from cancer in the Japanese population.
Highlights
In many developed countries, socioeconomic status (SES) is associated with cancer incidence and survival [1,2,3,4,5,6]
We identified 117,125 men and women aged 40–59 years for Cohort I and 40–69 years for Cohort II, with two areas excluded because information on cancer incidence and/ or deprivation index was not available
We examined the association between neighborhood deprivation index and cancer incidence, death and survival among Cohort I after adding education as a confounder to the multivariate model
Summary
Socioeconomic status (SES) is associated with cancer incidence and survival [1,2,3,4,5,6]. Japan has an extensive welfare system and equal access to health care [9], one study showed associations between poor gastric cancer survival and job status, such as unemployment and manual labor [10]. One Japanese study in a metropolitan area showed an inverse association between cervical and endometrial cancer survival and areal deprivation according to area unemployment rate [12]. We examined the association between neighborhood deprivation based on the Japanese Deprivation Index and the risk of incidence, mortality and survival from total and major cancers in the Japan Public Health Center-based Prospective Study
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