Socioeconomic environment and cancer incidence: a French population-based study in Normandy

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.

Small-area geographic and socioeconomic inequalities in colorectal tumour detection in France

“…Conflicting results emerged from these studies. However, our findings were consistent with two French population-based studies relying on cancer registries that failed to show any influence of socioeconomic deprivation on CRC incidence (Colonna and Sauleau, 2013;Bryère et al, 2014).…”

“…Although educational and socioeconomic inequalities in CRC mortality have been reported in France (Menvielle et al, 2007), studies on their impact on CRC incidence are scarce in France. Only two French studies were recently published showing no relationship between CRC incidence and socioeconomic environment (Colonna and Sauleau, 2013;Bryère et al, 2014). Studies from other western countries have provided only limited and inconsistent findings (Coughlin et al, 2006;Clegg et al, 2009;Donnelly and Gavin, 2011).…”

About invasive cervical cancer: a French population based study between 1998 and 2010

“…A poor socio-economic status is associated with a higher risk of cervical cancer [24,25], as indicated by the high proportion of women from deprived areas in our sample. However, once the invasive cervical cancer is diagnosed, the French healthcare system seems rather egalitarian with no difference in the prognosis of cancer according to socio economic level.…”

Correction of misclassification bias induced by the residential mobility in studies examining the link between socioeconomic environment and cancer incidence

“…That study assessed the link between socioeconomic environment and cancer incidence and was based on French cancer registry data [17]. The study population comprised 68,967 cases of cancer diagnosed between 1997 and 2009 in Normandy and collected by the local registries (Calvados cancer registry, digestive Calvados registry, Manche cancer registry, Malignant hematological Basse-Normandie registry and Multicentral mesothelioma registry).…”