Deprivation gradient for cancer incidence

Deprivation

Cancer is more common in deprived areas, 2006-10, England

 

The European age-standardised (AS) incidence rate Open a glossary item for all cancers combined (excluding non-melanoma skin cancer) is higher in the more socio-economically deprived groups than the least deprived groups.[1] For all cancers combined the deprivation gradient (the estimated difference in AS rates between the most and least deprived groups) is similar for males and females.

All Cancers Combined Excluding Non-Melanoma Skin Cancer (C00-C97 Excl. C44), European Age-Standardised Incidence Rates by Deprivation Quintile, England, 2006-2010

1 - least deprived 2 3 4 5 - most deprived Overall
Male AS Rate 390.9 404.1 416.8 442.5 485.0 423.6
AS Rate - 95% LCL 388.8 402.0 414.6 440.0 482.2 422.5
AS Rate - 95% UCL 393.0 406.2 419.0 444.9 487.8 424.6
AS Rate Ratio 1.0 1.0 1.1 1.1 1.2
Yearly Excess Cases 936 1,702 2,880 4,412 9,930
Female AS Rate 349.7 358.1 367.4 377.0 395.5 367.5
AS Rate - 95% LCL 347.7 356.2 365.4 374.9 393.2 366.6
AS Rate - 95% UCL 351.6 360.0 369.3 379.0 397.8 368.4
AS Rate Ratio 1.0 1.0 1.1 1.1 1.1
Yearly Excess Cases 746 1,490 1,947 2,638 6,820
Persons AS Rate 366.3 376.0 385.8 401.9 432.1 389.5
AS Rate - 95% LCL 364.8 374.6 384.4 400.3 430.3 388.8
AS Rate - 95% UCL 367.7 377.4 387.3 403.4 433.8 390.1
AS Rate Ratio 1.0 1.0 1.1 1.1 1.2
Yearly Excess Cases 1,492 2,810 4,319 6,662 15,283

Yearly excess cases for males and females in this table do not sum to persons due to rounding. 95% LCL and 95% UCL are the 95% lower and upper confidence limits Open a glossary item around the AS rate Open a glossary item.

All Cancers Combined Excluding Non-Melanoma Skin Cancer (C00-C97 Excl. C44), European Age-Standardised Incidence Rates by Deprivation Quintile, England, 2006-2010

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Incidence is associated with socio-economic deprivation for most cancer types in males and females.[1] For the majority of cancer types, European age-standardised (AS) incidence rates Open a glossary item are higher in the more deprived groups. The deprivation gap is greatest for smoking-related cancers such as laryngeal, lung and oral cavity cancers, which reflect the high prevalence of smoking in these groups.

European AS incidence rates are higher in the least deprived groups for a small number of cancers, including breast, prostate and malignant melanoma. For breast cancer, less socio-economically deprived women may be more likely to attend breast screening;[2] this also reflects higher prevalence of risk factors such as late first pregnancy, lower parity and hormone replacement therapy Open a glossary item (HRT) use in higher socio-economic groups. The higher incidence of prostate cancer amongst the least deprived males reflects higher inclination for prostate-specific antigen (PSA) Open a glossary item testing among men from higher socio-economic groups. Greater exposure to sunlight among the less socio-economically deprived groups is thought to cause the higher incidence of malignant melanoma.

Percentage Deprivation Gap in European Age-Standardised Incidence Rates, Statistically Significant Cancers, Males, England, 2006-2010

CUP = Cancer of unknown primary AML = Acute Myeloid Leukaemia ALL = Acute Lymphoblastic Leukaemia
 

Percentage Deprivation Gap in European Age-Standardised Incidence Rates, Statistically Significant Cancers, Females, England, 2006-2010

Brain Tumours = brain, other central nervous system (CNS) and intracranial tumours, including malignant, benign and uncertain or unknown behaviour tumours CUP = Cancer of unknown primary NHL = Non-Hodgkin lymphoma
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For all cancers combined the deprivation gap for incidence is larger for males than females in three time periods (1996-2000, 2001-2005, and 2006-2010). However, this difference is only statistically significant in the first two time periods, meaning that the deprivation gap between males and females has reduced over time for cancer incidence overall.[1]

Between 1996-2000 and 2006-2010 the deprivation gradient in incidence rates between the most and least deprived groups has stayed the same for most cancer types.[1] The deprivation gap has reduced in males in two cancer types over 15 years (cancer of unknown primary and stomach), but increased for six cancer types (female oropharynx, male and female kidney, male oesophagus; male non-Hodgkin lymphoma and vulva). Male malignant melanoma is the only cancer type where less deprived men have higher and more rapidly increasing incidence rates than more deprived men.

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There are around 22,000 extra cases of cancer, per year, in England because incidence rates are higher in more deprived groups for most cancers. However, there are also around 7,000 fewer cases because incidence rates are higher in the least deprived groups for some cancers (including breast [female only], prostate and malignant melanoma), so there is a net 'excess' of around 15,000 cases overall. Lung cancer has by far the largest number of excess cases because of socio-economic variation (11,700 persons per year).[1]

Excess Cases due to Socio-Economic Variation, per Year, England, 2006-2010

References

  1. Excess cases calculated by the Statistical Information Team at Cancer Research UK. Using data from Cancer Research UK and National Cancer Intelligence Network. May 2015.
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