Abstract
BackgroundThe struggle against social inequalities is a priority for many international organizations. The objective of the study was to quantify the cancer burden related to social deprivation by identifying the cancer sites linked to socioeconomic status and measuring the proportion of cases associated with social deprivation.MethodsThe study population comprised 68 967 cases of cancer diagnosed between 1997 and 2009 in Normandy and collected by the local registries. The social environment was assessed at an aggregated level using the European Deprivation Index (EDI). The association between incidence and socioeconomic status was assessed by a Bayesian Poisson model and the excess of cases was calculated with the Population Attributable Fraction (PAF).ResultsFor lung, lips-mouth-pharynx and unknown primary sites, a higher incidence in deprived was observed for both sexes. The same trend was observed in males for bladder, liver, esophagus, larynx, central nervous system and gall-bladder and in females for cervix uteri. The largest part of the incidence associated with deprivation was found for cancer of gall-bladder (30.1%), lips-mouth-pharynx (26.0%), larynx (23.2%) and esophagus (19.6%) in males and for unknown primary sites (18.0%) and lips-mouth-pharynx (12.7%) in females. For prostate cancer and melanoma in males, the sites where incidence increased with affluence, the part associated with affluence was respectively 9.6% and 14.0%.ConclusionsBeyond identifying cancer sites the most associated with social deprivation, this kind of study points to health care policies that could be undertaken to reduce social inequalities.
Highlights
The struggle against social inequalities is a priority for many international organizations
The objective of the study was to quantify the part of the cancer burden related to social deprivation
We firstly identified the cancer sites linked to the socioeconomic status of the living area and secondly measured for each one the proportion of cases of cancer associated with social deprivation
Summary
The struggle against social inequalities is a priority for many international organizations. The objective of the study was to quantify the cancer burden related to social deprivation by identifying the cancer sites linked to socioeconomic status and measuring the proportion of cases associated with social deprivation. Social deprivation can be singled out as responsible for part of this cancer incidence and the Public action to reduce this gradient must rely in part on the proper assessment of the burden of cancer associated with social environment and on the knowledge of the mechanisms underlying such inequalities. Studies of this type have initially focused on mortality data [2,3]. The relationship between cancer incidence and socioeconomic status is dynamic and needs to be continuously monitored
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