Socio-economic inequalities in the incidence of four common cancers: a population-based registry study

Tweed, E.J. , Allardice, G.M., McLoone, P. and Morrison, D.S. (2018) Socio-economic inequalities in the incidence of four common cancers: a population-based registry study. Public Health, 154, pp. 1-10. (doi:10.1016/j.puhe.2017.10.005) (PMID:29128730) (PMCID:PMC5764071)

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Abstract

Objectives: To investigate the relationship between socio-economic circumstances and cancer incidence in Scotland in recent years. Study design: Population-based study using cancer registry data. Methods: Data on incident cases of colorectal, lung, female breast, and prostate cancer diagnosed between 2001 and 2012 were obtained from a population-based cancer registry covering a population of approximately 2.5 million people in the West of Scotland. Socio-economic circumstances were assessed based on postcode of residence at diagnosis, using the Scottish Index of Multiple Deprivation (SIMD). For each cancer, crude and age-standardised incidence rates were calculated by quintile of SIMD score, and the number of excess cases associated with socio-economic deprivation was estimated. Results: 93,866 cases met inclusion criteria, comprising 21,114 colorectal, 31,761 lung, 23,757 female breast, and 15,314 prostate cancers. Between 2001 and 2006, there was no consistent association between socio-economic circumstances and colorectal cancer incidence, but 2006–2012 saw an emerging deprivation gradient in both sexes. The incidence rate ratio (IRR) for colorectal cancer between most deprived and least deprived increased from 1.03 (95% confidence interval [CI] 0.91–1.16) to 1.24 (95% CI 1.11–1.39) during the study period. The incidence of lung cancer showed the strongest relationship with socio-economic circumstances, with inequalities widening across the study period among women from IRR 2.66 (95% CI 2.33–3.05) to 2.91 (95% CI 2.54–3.33) in 2001–03 and 2010–12, respectively. Breast and prostate cancer showed an inverse relationship with socio-economic circumstances, with lower incidence among people living in more deprived areas. Conclusion: Significant socio-economic inequalities remain in cancer incidence in the West of Scotland, and in some cases are increasing. In particular, this study has identified an emerging, previously unreported, socio-economic gradient in colorectal cancer incidence among women as well as men. Actions to prevent, mitigate, and undo health inequalities should be a public health priority.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McLoone, Mr Philip and Tweed, Dr Emily and Morrison, Dr David and Allardice, Dr Gwen
Authors: Tweed, E.J., Allardice, G.M., McLoone, P., and Morrison, D.S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:Public Health
Publisher:Elsevier
ISSN:0033-3506
ISSN (Online):1476-5616
Published Online:10 November 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in Public Health 154: 1-10
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
727651SPHSU Core Renewal: Measuring and Analysing Socioeconomic Inequalities in Health Research ProgrammeAlastair LeylandMedical Research Council (MRC)MC_UU_12017/13IHW - MRC/CSO SPHU
727671SPHSU Core Renewal: Informing Healthy Public Policy Research ProgrammePeter CraigMedical Research Council (MRC)MC_UU_12017/15IHW - MRC/CSO SPHU