Socioeconomic inequalities in cancer mortality between and within countries in Europe: a population-based study

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Socioeconomic inequalities in cancer mortality between and within countries in Europe : a population-based study

Vaccarella, Salvatore (författare): International Agency for Research on Cancer (IARC/WHO), France

Georges, Damien (författare): International Agency for Research on Cancer (IARC/WHO), France

Bray, Freddie (författare): International Agency for Research on Cancer (IARC/WHO), France

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Ginsburg, Ophira (författare): International Agency for Research on Cancer (IARC/WHO), France; U.S. National Cancer Institute Maryland, USA

Charvat, Hadrien (författare): International Agency for Research on Cancer (IARC/WHO), France

Martikainen, Pekka, 1966- (författare): Stockholms universitet,Institutionen för folkhälsovetenskap,University of Helsinki, Finland; Max Planck Institute for Demographic Research, Germany

Brønnum-Hansen, Henrik (författare): University of Copenhagen, Denmark

Deboosere, Patrick (författare): Vrije Universiteit Brussel, Belgium

Bopp, Matthias (författare): University of Zurich, Switzerland

Leinsalu, Mall, 1958- (författare): Södertörns högskola,SCOHOST (Stockholm Centre for Health and Social Change),National Institute for Health Development, Estonia

Artnik, Barbara (författare): University of Ljubljana, Slovenia

Lorenzoni, Valentina (författare): Scuola Superiore Sant'Anna, Italy

De Vries, Esther (författare): Pontificia Universidad Bogota, Colombia

Marmot, Michael (författare): University College London Institute of Health Equity, England

Vineis, Paolo (författare): Imperial College, England

Mackenbach, Johan (författare): Erasmus MC, Netherlands

Nusselder, Wilma (författare): Erasmus MC, Netherlands

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International Agency for Research on Cancer (IARC/WHO), France International Agency for Research on Cancer (IARC/WHO), France; US. National Cancer Institute Maryland, USA (creator_code:org_t)

Elsevier, 2023
2023
Engelska.
Ingår i: The Lancet Regional Health. - : Elsevier. - 2666-7762. ; 25

Relaterad länk:: https://doi.org/10.1...; visa fler...; https://urn.kb.se/re...; https://doi.org/10.1...; https://urn.kb.se/re...; visa färre...

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Abstract Ämnesord

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BACKGROUND: Reducing socioeconomic inequalities in cancer is a priority for the public health agenda. A systematic assessment and benchmarking of socioeconomic inequalities in cancer across many countries and over time in Europe is not yet available.METHODS: Census-linked, whole-of-population cancer-specific mortality data by socioeconomic position, as measured by education level, and sex were collected, harmonized, analysed, and compared across 18 countries during 1990-2015, in adults aged 40-79. We computed absolute and relative educational inequalities; temporal trends using estimated-annual-percentage-changes; the share of cancer mortality linked to educational inequalities.FINDINGS: Everywhere in Europe, lower-educated individuals have higher mortality rates for nearly all cancer-types relative to their more highly-educated counterparts, particularly for tobacco/infection-related cancers [relative risk of lung cancer mortality for lower- versus higher-educated = 2.4 (95% confidence intervals: 2.1-2.8) among men; = 1.8 (95% confidence intervals: 1.5-2.1) among women]. However, the magnitude of inequalities varies greatly by country and over time, predominantly due to differences in cancer mortality among lower-educated groups, as for many cancer-types higher-educated have more similar (and lower) rates, irrespective of the country. Inequalities were generally greater in Baltic/Central/East-Europe and smaller in South-Europe, although among women large and rising inequalities were found in North-Europe (relative risk of all cancer mortality for lower- versus higher-educated ≥1.4 in Denmark, Norway, Sweden, Finland and the England/Wales). Among men, rate differences (per 100,000 person-years) in total-cancer mortality for lower-vs-higher-educated groups ranged from 110 (Sweden) to 559 (Czech Republic); among women from approximately null (Slovenia, Italy, Spain) to 176 (Denmark). Lung cancer was the largest contributor to inequalities in total-cancer mortality (between-country range: men, 29-61%; women, 10-56%). 32% of cancer deaths in men and 16% in women (but up to 46% and 24%, respectively in Baltic/Central/East-Europe) were associated with educational inequalities.INTERPRETATION: Cancer mortality in Europe is largely driven by levels and trends of cancer mortality rates in lower-education groups. Even Nordic-countries, with a long-established tradition of equitable welfare and social justice policies, witness increases in cancer inequalities among women. These results call for a systematic measurement, monitoring and action upon the remarkable socioeconomic inequalities in cancer existing in Europe.FUNDING: This study was done as part of the LIFEPATH project, which has received financial support from the European Commission (Horizon 2020 grant number 633666), and the DEMETRIQ project, which received support from the European Commission (grant numbers FP7-CP-FP and 278511). SV and WN were supported by the French Institut National du Cancer (INCa) (Grant number 2018-116). PM was supported by the Academy of Finland (#308247, # 345219) and the European Research Council under the European Union's Horizon 2020 research and innovation programme (grant agreement No 101019329). The work by Mall Leinsalu was supported by the Estonian Research Council (grant PRG722).

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Nyckelord

Between- and within countries cancer inequalities
Cancer disparities
Cancer mortality
Social gradient
Socioeconomic inequalities
Östersjö- och Östeuropaforskning
Baltic and East European studies

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Av författaren/redakt...: Vaccarella, Salv ...; Georges, Damien; Bray, Freddie; Ginsburg, Ophira; Charvat, Hadrien; Martikainen, Pek ...; visa fler...; Brønnum-Hansen, ...; Deboosere, Patri ...; Bopp, Matthias; Leinsalu, Mall, ...; Artnik, Barbara; Lorenzoni, Valen ...; De Vries, Esther; Marmot, Michael; Vineis, Paolo; Mackenbach, Joha ...; Nusselder, Wilma; visa färre...

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