Area-level deprivation and oral cancer in England 2012–2016

Ravaghi, Vahid; Durkan, C.; Jones, K.W.; Girdler, Rebecca; Mair-Jenkins, John; Davies, Gill; Wilcox, David; Dermont, Mark; White, Sandra; Dailey, Yvonne; Morris, Alexander

doi:10.1016/j.canep.2020.101840

Cited by 12 publications

(16 citation statements)

References 27 publications

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“…Most oral cancers, particularly in South Asia, are preceded by long‐standing oral potentially malignant disorders (OPMDs), 6 allowing for early detection. Nonetheless, barriers to care, a lack of general awareness and low levels of health literacy, perceived social stigma, and poverty frequently result in a late‐stage diagnosis of oral cancer 7–11 . This is linked to health‐system and country‐specific inequalities in treatment outcomes such as low 5‐year survival rates and poor quality of life 2–4,7 …”

Section: Introductionmentioning

confidence: 99%

“…Social inequalities in health denote systematic differences in any given health outcome due to social status 12,13 and are operationalized by individual, household, neighbourhood, and/or country‐based socio‐economic indicators. Social inequalities in oral health are ubiquitous not only across populations, geographies, cultures, health systems and economic structures but also in the methods of social classification and in oral health and disease 7,14–17 . Oral cancer is no exception being attributed to socially determined differences in life opportunities, behaviours, beliefs and exposures to a plethora of factors that reduce or increase the risks 13–17 .…”

Section: Introductionmentioning

confidence: 99%

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An overview of the burden of oral cancer in Sri Lanka and its inequalities in the face of contemporary economic and social malaise

Perera

Amarasinghe

Jayasinghe

et al. 2023

Comm Dent Oral Epid

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Objectives: Over the past several decades, oral cancer has been the most common malignancy among Sri Lankan males and the top 10 cancer among females, disproportionately affecting low socio-economic groups. Sri Lanka is a lower-middle-income developing country (LMIC), currently striking through an economic crisis, and social and political unrest. Occurring at an accessible body site and predominantly attributed to potentially modifiable health-related behaviours, oral cancer should be preventable and controllable. Unfortunately, broader contextual factors that are socio-cultural, environmental, economic, and political and mediated through social determinants of people's lives consistently hinder progress. Many LMICs with a high burden of oral cancer are now gripped by economic crises, consequent social and political unrest, all compounded by reduced public health investments. The aim of this review is to provide a critical commentary on key aspects of oral cancer epidemiology including inequalities, using Sri Lanka as a case study. Methods:The review synthesizes evidence from multiple data sources, such as published studies, web-based national cancer incidence data, national surveys on smokeless tobacco (ST) and areca nut use, smoking and alcohol consumption, poverty headcount ratios, economic growth, and Gross Domestic Product (GDP) health expenditure. National trends in the oral cancer, ST use, smoking and alcohol consumption in Sri Lanka are identified alongside inequalities.Results: Using these evidence sources, we discuss 'where are we now?', together with the availability, accessibility and affordability of oral cancer treatment services, oral cancer prevention and control programmes, tobacco and alcohol control policies, and finally, outline macroeconomic perspectives of Sri Lanka.Conclusions: Finally, we speculate, 'where to next?' Our overarching goal of this review is to initiate a critical discourse on bridging the gaps and crossing the divides to tackle oral cancer inequalities in LMIC such as Sri Lanka.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An overview of the burden of oral cancer in Sri Lanka and its inequalities in the face of contemporary economic and social malaise

Perera

Amarasinghe

Jayasinghe

et al. 2023

Comm Dent Oral Epid

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“…Indeed, some studies could show a certain association between socioeconomic factors and oral cancer. Admittedly, these studies were conducted in countries with different health systems (16)(17)(18)(19)(20)(21). In many health systems high quality medical care is only accessible for patients with higher socioeconomic status which could be one reason for treatment and survival differences found in these studies.…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic disparities between oral cavity cancer patients in Germany

Muallah

Matschke

Muallah

et al. 2022

Front. Public Health

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ObjectiveIn many countries the access to high quality medical service depends on socioeconomic factors. Therefore, these factors are associated with the treatment and prognosis of many diseases. In Germany health care is claimed to be independent from such factors due to obligatory health insurance and a well-developed medical infrastructure. Thus, socioeconomically caused health disparities should be absent. The aim of this study was to analyze the association between socioeconomic factors and the survival of oral cavity cancer in Germany.Patients and methodsIn this descriptive cohort study socioeconomic status related factors as well as demographic, tumor-specific, and comorbidity factors of 500 patients treated for oral cavity cancer were obtained in the university hospital of Dresden. Pearson correlation was used to describe associations between continuous variables. Associations between categorical variables were assessed using the chi-square test. Overall and recurrence-free survival were studied using the Kaplan-Meier method. Log-rank test was carried out to test between-group differences. Cox proportional hazard models were used to estimate the risk of death and the risk of recurrence.ResultsSignificant differences in overall survival were found between the different educational levels and sex. Seventy-nine percent of the patients did not have a university degree or master craftsman/craftswoman. Less discrepancy was observed according to the marital status (49.4% married/engaged vs. 47.8% single, divorced, or widowed). In the multivariable analysis only sex, age at diagnosis, the Charlson score, the number of positive lymph nodes, and the nodal status were identified as independent predictors for overall survival whereas sex and the age at diagnosis were identified as independent predictors for recurrence-free survival.ConclusionDespite the equitable health system in Germany, significant associations between overall survival of oral cavity cancer and different socioeconomic factors could be found. For elimination of these disparities, health education programs should be established in socially deprived areas. Furthermore, clinicians should keep these factors in mind when determining recall periods for dental check-ups.

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“…Lack of material and social resources may explain why worse health outcomes are often observed for residents of more deprived areas (2). Area deprivation relates to a large number of adverse health outcomes, e.g., coronary heart disease, type 2 diabetes or cancer (3)(4)(5)(6). To analyze those area-level health disparities, deprivation indices are widely used (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

“…However, it should be considered that geographical patterns of health inequalities already existed before the pandemic. In particular, non-communicable diseases are unequally distributed in the population which could be related to area deprivation (3)(4)(5)(6). Such geographical patterns of health inequality may also apply to COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Area Deprivation and COVID-19 Incidence and Mortality in Bavaria, Germany: A Bayesian Geographical Analysis

Manz

Schwettmann

Mansmann

et al. 2022

Front. Public Health

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BackgroundArea deprivation has been shown to be associated with various adverse health outcomes including communicable as well as non-communicable diseases. Our objective was to assess potential associations between area deprivation and COVID-19 standardized incidence and mortality ratios in Bavaria over a period of nearly 2 years. Bavaria is the federal state with the highest infection dynamics in Germany and demographically comparable to several other European countries.MethodsIn this retrospective, observational ecological study, we estimated the strength of associations between area deprivation and standardized COVID-19 incidence and mortality ratios (SIR and SMR) in Bavaria, Germany. We used official SARS-CoV-2 reporting data aggregated in monthly periods between March 1, 2020 and December 31, 2021. Area deprivation was assessed using the quintiles of the 2015 version of the Bavarian Index of Multiple Deprivation (BIMD 2015) at district level, analyzing the overall index as well as its single domains.ResultsDeprived districts showed higher SIR and SMR than less deprived districts. Aggregated over the whole period, the SIR increased by 1.04 (95% confidence interval (95% CI): 1.01 to 1.07, p = 0.002), and the SMR by 1.11 (95% CI: 1.07 to 1.16, p < 0.001) per BIMD quintile. This represents a maximum difference of 41% between districts in the most and least deprived quintiles in the SIR and 110% in the SMR. Looking at individual months revealed clear linear association between the BIMD quintiles and the SIR and SMR in the first, second and last quarter of 2021. In the summers of 2020 and 2021, infection activity was low.ConclusionsIn more deprived areas in Bavaria, Germany, higher incidence and mortality ratios were observed during the COVID-19 pandemic with particularly strong associations during infection waves 3 and 4 in 2020/2021. Only high infection levels reveal the effect of risk factors and socioeconomic inequalities. There may be confounding between the highly deprived areas and border regions in the north and east of Bavaria, making the relationship between area deprivation and infection burden more complex. Vaccination appeared to balance incidence and mortality rates between the most and least deprived districts. Vaccination makes an important contribution to health equality.

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Area-level deprivation and oral cancer in England 2012–2016

Cited by 12 publications

References 27 publications

An overview of the burden of oral cancer in Sri Lanka and its inequalities in the face of contemporary economic and social malaise

An overview of the burden of oral cancer in Sri Lanka and its inequalities in the face of contemporary economic and social malaise

Socioeconomic disparities between oral cavity cancer patients in Germany

Area Deprivation and COVID-19 Incidence and Mortality in Bavaria, Germany: A Bayesian Geographical Analysis

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