Abstract
BackgroundWe identify socioeconomic disparities by region in cancer morbidity and mortality in England for all-cancer and type-specific cancers, and use incidence data to quantify the impact of cancer diagnosis delays on cancer deaths between 2001–2016.Methods and findingsWe obtain population cancer morbidity and mortality rates at various age, year, gender, deprivation, and region levels based on a Bayesian approach. A significant increase in type-specific cancer deaths, which can also vary among regions, is shown as a result of delay in cancer diagnoses. Our analysis suggests increase of 7.75% (7.42% to 8.25%) in female lung cancer mortality in London, as an impact of 12-month delay in cancer diagnosis, and a 3.39% (3.29% to 3.48%) increase in male lung cancer mortality across all regions. The same delay can cause a 23.56% (23.09% to 24.30%) increase in male bowel cancer mortality. Furthermore, for all-cancer mortality, the highest increase in deprivation gap happened in the East Midlands, from 199 (186 to 212) in 2001, to 239 (224 to 252) in 2016 for males, and from 114 (107 to 121) to 163 (155 to 171) for females. Also, for female lung cancer, the deprivation gap has widened with the highest change in the North West, e.g. for incidence from 180 (172 to 188) to 272 (261 to 282), whereas it has narrowed for prostate cancer incidence with the biggest reduction in the South West from 165 (139 to 190) in 2001 to 95 (72 to 117) in 2016.ConclusionsThe analysis reveals considerable disparities in all-cancer and some type-specific cancers with respect to socioeconomic status. Furthermore, a significant increase in cancer deaths is shown as a result of delays in cancer diagnoses which can be linked to concerns about the effect of delay in cancer screening and diagnosis during the COVID-19 pandemic. Public health interventions at regional and deprivation level can contribute to prevention of cancer deaths.
Highlights
Cancer is one of the major causes of morbidity and mortality in England and Wales
The analysis reveals considerable disparities in all-cancer and some type-specific cancers with respect to socioeconomic status
A significant increase in cancer deaths is shown as a result of delays in cancer diagnoses which can be linked to concerns about the effect of delay in cancer screening and diagnosis during the COVID-19 pandemic
Summary
Cancer is one of the major causes of morbidity and mortality in England and Wales. The Office for National Statistics (ONS) reported that cancer has remained the main cause of death since 2011 by accounting for 28.1% of all deaths in 2017 [1, 2]. Changes in type-specific cancer mortality and incidence rates by region and socioeconomic deprivation are less well-characterised in England [19,20,21,22,23,24,25,26]. In this paper we focus on socioeconomic disparities for cancer morbidity and mortality in nine regions in England for the period 2001–2016. Our research provides important findings related to socioeconomic inequalities in cancer morbidity and mortality in England, based on comprehensive modelling of relevant rates. We identify socioeconomic disparities by region in cancer morbidity and mortality in England for all-cancer and type-specific cancers, and use incidence data to quantify the impact of cancer diagnosis delays on cancer deaths between 2001–2016
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