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Córdoba-Doña JA, Benítez-Rodríguez E, Escolar-Pujolar A, Santos-Sánchez V. Age-period-cohort analysis of lung cancer mortality inequalities in Southern Spain: missed opportunities for implementing equitable tobacco control policies. Int J Equity Health 2023; 22:132. [PMID: 37438851 DOI: 10.1186/s12939-023-01946-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/28/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Lung cancer mortality in European countries shows different epidemiological patterns according to sex and socioeconomic variables. Some countries show decreasing rates in both sexes, while others show a delayed profile, with increasing mortality in women, inconsistently influenced by socioeconomic status. Our aim was to evaluate the effect of age, period and birth cohort on lung cancer mortality inequalities in men and women in Andalusia, the southernmost region in Spain. METHODS We used the Longitudinal Database of the Andalusian Population, which collects demographic and mortality data from the 2001 census cohort of more than 7.35 million Andalusians, followed up between 2002 and 2016. Mortality rates were calculated for men and women by educational level, and small-area deprivation. Poisson models were used to assess trends in socioeconomic inequalities in men and women. Finally, age-period-cohort (APC) models were used separately for each educational level and gender. RESULTS There were 39,408 lung cancer deaths in men and 5,511 in women, yielding crude mortality rates of 78.1 and 11.4 × 105 person-years, respectively. In men higher mortality was found in less educated groups and inequalities increased during the study period: i.e. the rate ratio for primary studies compared to university studies increased from 1.30 (CI95:1.18-1.44) to 1.57 (CI95:1.43-1.73). For women, educational inequalities in favour of the less educated tended to decrease moderately. In APC analysis, a decreasing period effect in men and an increasing one in women were observed. Cohort effect differed significantly by educational level. In men, the lower the educational level, the earlier the peak effect was reached, with a 25-year difference between the least-educated and college-educated. Conversely, college-educated women reached the peak effect with a 12-year earlier cohort than the least-educated women. The decline of mortality followed the same pattern both in men and women, with the best-educated groups experiencing declining rates with earlier birth cohorts. CONCLUSIONS Our study reveals that APC analysis by education helps to uncover changes in trends occurring in different socioeconomic and gender groups, which, combined with data on smoking prevalence, provide important clues for action. Despite its limitations, this approach to the study of lung cancer inequalities allows for the assessment of gaps in historical and current tobacco policies and the identification of population groups that need to be prioritised for public health interventions.
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Affiliation(s)
- Juan Antonio Córdoba-Doña
- Preventive Medicine and Public Health Unit, Hospital Universitario de Jerez, Jerez de la Frontera (Cádiz), Jerez de la Frontera, Spain.
- Instituto de Investigación e Innovación Biomédica de Cádiz, INIBiCA, Cádiz, Spain.
| | - Encarnación Benítez-Rodríguez
- Instituto de Investigación e Innovación Biomédica de Cádiz, INIBiCA, Cádiz, Spain
- Preventive Medicine and Public Health Unit, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | | | - Vanessa Santos-Sánchez
- Instituto de Investigación e Innovación Biomédica de Cádiz, INIBiCA, Cádiz, Spain
- Departamento de Sociología, Trabajo Social y Salud Pública, Universidad de Huelva, Huelva, Spain
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Venchiarutti RL, Pho L, Clark JR, Palme CE, Young JM. A qualitative exploration of the facilitators and barriers to early diagnosis and treatment of head and neck cancer: Perceptions of patients and carers. Eur J Cancer Care (Engl) 2022; 31:e13718. [PMID: 36178016 PMCID: PMC9788178 DOI: 10.1111/ecc.13718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/07/2022] [Accepted: 09/14/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The objective of this study to explore experiences of patients and carers of the pathway to diagnosis and treatment of head and neck cancer (HNC), focusing on differences based on remoteness of residence. METHODS Patients ≥6 months post-treatment completion, and their carers, were recruited. Semi-structured interviews, guided by the Model of Pathways to Treatment as the theoretical framework, were conducted to examine pathways to treatment of HNC and facilitators and barriers to early diagnosis and treatment. Thematic analysis with an iterative and data-driven approach was used to identify themes. RESULTS A total of 39 patients and 17 carers participated in the interviews. Facilitators of timely diagnosis and treatment included a sense of urgency from health care professionals (HCPs), advocacy by the HCP or carers, and leveraging social capital. Distance to services, financial costs, and a perceived lack of emotional investment by HCPs arose as barriers to timely diagnosis and treatment. Participants were often able to rationalise that not all delays were negative, depending causes and expected impact on cancer management. CONCLUSION The findings highlight the complex nature of factors facilitating and impeding early HNC diagnosis and treatment that may be targeted in interventions to support patients and meet important benchmarks for high-quality cancer care.
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Affiliation(s)
- Rebecca L. Venchiarutti
- Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneyCamperdownNew South WalesAustralia,Department of Head and Neck SurgeryChris O'Brien LifehouseCamperdownNew South WalesAustralia
| | - Lily Pho
- Sydney Local Health District Nursing and Midwifery Executive UnitSydney Local Health DistrictCamperdownNew South WalesAustralia
| | - Jonathan R. Clark
- Department of Head and Neck SurgeryChris O'Brien LifehouseCamperdownNew South WalesAustralia,Royal Prince Alfred Institute of Academic SurgerySydney Local Health DistrictCamperdownNew South WalesAustralia,Central Clinical School, Faculty of Medicine and HealthThe University of SydneyCamperdownNew South WalesAustralia
| | - Carsten E. Palme
- Department of Head and Neck SurgeryChris O'Brien LifehouseCamperdownNew South WalesAustralia,Royal Prince Alfred Institute of Academic SurgerySydney Local Health DistrictCamperdownNew South WalesAustralia,Central Clinical School, Faculty of Medicine and HealthThe University of SydneyCamperdownNew South WalesAustralia
| | - Jane M. Young
- Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneyCamperdownNew South WalesAustralia,The Daffodil CentreThe University of Sydney, a joint venture with Cancer Council NSWSydneyNew South WalesAustralia
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3
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Derette K, Rollet Q, Launay L, Launoy G, Bryere J. Evolution of socioeconomic inequalities in cancer incidence between 2006 and 2016 in France: a population-based study. Eur J Cancer Prev 2022; 31:473-481. [PMID: 35044985 DOI: 10.1097/cej.0000000000000732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The existence of socioeconomic inequalities in cancer incidence is now well established and their reduction is a priority in many countries. This study aimed to measure the evolution of socioeconomic inequalities in the incidence of the most common cancers in France, over an 11-year period. METHODS The study focused on 19 cancer entities (16 solid tumors and 3 hematological malignancies). Data are obtained from the French Network of Cancer Registries, representing 604 205 cancer cases. Each patient address was geolocalized and assigned to an IRIS, the smallest geographic unit in France. The French version of the European Deprivation Index was used to measure the level of deprivation in each IRIS. A generalized linear mixed model was used to account for the longitudinal nature of the data and to assess the evolution of socioeconomic inequalities. RESULTS A significant evolution of the social gradient of incidence over time was highlighted for five cancer entities and all entities combined. For lung cancer for both sexes and bladder cancer in men, more frequent in deprived areas, the social gradient in incidence tended to decrease over time. For breast cancer in women and lymphocytic leukemia in men, more frequent in affluent areas, the gap continues to widen. CONCLUSION Cancer entities with large disparities continued to present social inequalities in incidence without exacerbation with time. The few temporal evolutions observed do not show a worsening of the social gradient of incidence to the disadvantage of the most deprived areas, but rather an increase in incidence that is greater in the most affluent areas.
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Affiliation(s)
- Krystaelle Derette
- ANTICIPE, Normandy University, Unicaen, INSERM, Centre François Baclesse, Avenue du Général Harris, Caen, France
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Age-period-cohort analysis of lung cancer mortality in China and Australia from 1990 to 2019. Sci Rep 2022; 12:8410. [PMID: 35589955 PMCID: PMC9120450 DOI: 10.1038/s41598-022-12483-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 05/09/2022] [Indexed: 11/18/2022] Open
Abstract
Lung cancer (LC) is the leading cause of cancer death in China and Australia, the countries with different socioenvironmental contexts in the Western Pacific Region. Comparing the age-period-cohort effect on LC mortality (LCM) between the two countries can help plan interventions and draw lessons for countries in the region. We collected LCM estimates between 1990 and 2019 from the GBD 2019. Age-period-cohort modelling was applied to compute the net drift, local drift, cross-sectional age curve, longitudinal age curve, and the rate ratios (RRs) of period and cohort. China had a higher LC age-standardized mortality rate than Australia in 2019 (men: 58.10 [95% uncertainty interval (UI): 46.53, 70.89] vs. 30.13 [95% UI: 27.88, 32.31]/100,000 population; women: 22.86 [95% UI: 18.52, 27.52] vs. 17.80 [95% UI: 15.93, 19.34]/100,000 population). Period and cohort effects on LCM improved more markedly among Australian men (RR for period effect, from 1.47 [95% confidence interval (CI) 1.41, 1.53] to 0.79 [95% CI 0.75, 0.84]; RR for cohort effect, from 2.56 [95% CI 2.44, 2.68] to 0.36 [95% CI 0.11, 1.18]) and Chinese women (RR for period effect, from 1.06 [95% CI 1.01, 1.11] to 0.85 [95% CI 0.82, 0.89]; RR for cohort effect, from 0.71 [95% CI 0.65, 0.78] to 0.51 [95% CI 0.26, 1.03]) during the study period and birth cohort. The LCM in Chinese population aged 65 to 79 and Australian women aged 75 to 79 increased. Smoking and particulate matter (PM) contributed most to LCM in China, while smoking and occupational carcinogens contributed most in Australia. Decreasing period and cohort risks for LCM attributable to smoking and PM were more remarkable in Australia than in China. The LCM attributable to occupational carcinogens was higher in Australia than in China, particularly for those aged 60 to 79. Vigorous tobacco and PM control, which brought a substantial decline in LCM in Australia, may help reduce LCM in China. Australia should highlight LC prevention among people with occupational exposure. Chinese aged ≥ 65 and Australian women aged ≥ 75 should be the priorities for LC interventions.
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Pizzato M, Martinsen JI, Heikkinen S, Vignat J, Lynge E, Sparén P, La Vecchia C, Pukkala E, Vaccarella S. Socioeconomic status and risk of lung cancer by histological subtype in the Nordic countries. Cancer Med 2022; 11:1850-1859. [PMID: 35166068 PMCID: PMC9041078 DOI: 10.1002/cam4.4548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/10/2021] [Accepted: 12/10/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND While the excess in lung cancer risk among lower socioeconomic status individuals has been widely described, the magnitude of this association across lung cancer subtypes, as well as histotype-related long-term incidence trends, are inconclusively reported. AIMS We explored the variation in the incidence of the three main lung cancer histotypes (i.e. squamous cell carcinoma, small cell carcinoma and adenocarcinoma) by socioeconomic status (SES, i.e. upper and lower white collar, upper and lower blue collar, and farming/forestry/fishing) in the adult population of four Nordic countries (i.e. Sweden, Norway, Finland and Denmark). MATERIALS & METHODS We have used data from the Nordic Occupational Cancer Study (NOCCA), computing age-standardized incidence rates per 100,000 person-years truncated at ages 50-69 years, by sex, histotype, country and SES, for the period 1971-2005. We estimated relative risks and the corresponding 95% confidence intervals through Poisson regression models, including terms for SES, age, sex and country, as indicated. RESULTS A clear socioeconomic gradient, with a progressive increase in lung cancer risk as SES level decreases, was observed in all subtypes and in both sexes. Favourable lung cancer incidence trends were seen among men for squamous cell and small cell carcinomas, although for adenocarcinomas rates were increasing everywhere except for Finland. Among women, upward temporal trends were seen in all SES groups and for all subtypes, although rates increased to a greater extent for low, compared to high, SES, especially in Denmark and Norway. Farmers showed comparatively lower risks compared to other SES categories. DISCUSSION This prospective cohort study shows that substantial socioeconomic inequalities in the incidence of the most important lung cancer histotypes exist in the Nordic Countries, and that these inequalities are on the rise, especially among women. CONCLUSION Smoking habits are likely to largely explain the observed social gradient for lung cancer histotypes in both sexes.
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Affiliation(s)
- Margherita Pizzato
- Department of Clinical Sciences and Community HealthUniversità degli Studi di MilanoMilanItaly
| | | | | | - Jerome Vignat
- International Agency for Research on CancerLyonFrance
| | - Elsebeth Lynge
- Nykøbing Falster HospitalUniversity of CopenhagenDenmark
| | - Pär Sparén
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholm
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community HealthUniversità degli Studi di MilanoMilanItaly
| | - Eero Pukkala
- Finnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer ResearchHelsinkiFinland
- Faculty of Social Sciences, Tampere UniversityTampereFinland
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Shah M, Parmar A, Chan KKW. Socioeconomic disparity trends in diagnostic imaging, treatments, and survival for non-small cell lung cancer 2007-2016. Cancer Med 2020; 9:3407-3416. [PMID: 32196964 PMCID: PMC7221447 DOI: 10.1002/cam4.2978] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/30/2019] [Accepted: 02/19/2020] [Indexed: 12/25/2022] Open
Abstract
Socioeconomic status (SES) has led to treatment and survival disparities; however, limited data exist for non‐small cell lung cancer (NSCLC). This study investigates the impact of SES on NSCLC diagnostic imaging, treatment, and overall survival (OS), and describes temporal disparity trends. The Ontario Cancer Registry was used to identify NSCLC patients diagnosed between 2007 and 2016. Through linkage to administrative datasets, patients’ demographics, imaging, treatment, and survival were obtained. Based on median household neighborhood income, the Ontario population was divided into five income quintiles (Q1‐Q5; Q1 = lowest income). Multivariable regressions assessed SES association with OS, imaging, treatment receipt, and treatment delay, and their interaction with year of diagnosis to understand temporal trends. Endpoints were adjusted for demographics, stage and comorbidities, along with treatments and imaging for OS. A total of 50 542 patients were identified. Higher SES patients (Q5 vs. Q1) showed improved 5‐year OS (hazard ratio, 0.89; 95% confidence interval [CI], 0.87‐0.92; P < .0001) and underwent greater magnetic resonance imaging head (stages IA‐IV; odds ratio [OR], 1.24; 95% CI, 1.16‐1.32; P < .0001), lung resection (IA‐IIIA; OR, 1.58; 95% CI, 1.43‐1.74; P < .0001), platinum‐based vinorelbine adjuvant chemotherapy (IB‐IIIA; OR, 1.63; 95% CI, 1.39‐1.92; P < .0001), palliative radiation (IV; OR, 1.14; 95% CI, 1.05‐1.25; P = .023), and intravenous chemotherapy (IV; OR, 1.45; 95% CI, 1.32‐1.60; P < .0001). Lower SES patients underwent greater thoracic radiation (IA‐IIIB; OR, 0.86; 95% CI, 0.79‐0.94; P = .0003). Across 2007‐2016, socioeconomic disparities remain largely unchanged (interaction P > .05) despite widening income inequality.
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Affiliation(s)
- Monica Shah
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ambica Parmar
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Kelvin K W Chan
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Canadian Centre for Applied Research in Cancer Control, Toronto, ON, Canada.,Cancer Care Ontario, Toronto, ON, Canada
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7
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Xie L, Qian Y, Liu Y, Li Y, Jia S, Yu H, Wang C, Qian B, Bao P. Distinctive lung cancer incidence trends among men and women attributable to the period effect in Shanghai: An analysis spanning 42 years. Cancer Med 2020; 9:2930-2939. [PMID: 32073760 PMCID: PMC7163103 DOI: 10.1002/cam4.2917] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/22/2020] [Accepted: 01/22/2020] [Indexed: 12/23/2022] Open
Abstract
Background Many previous studies reported secular trend of lung cancer incidence and mortality, but little is known about the possible reasons for these trends. Methods Data were obtained from Shanghai Cancer Registry. Age‐standardized rates were calculated and average annual percent changes (AAPCs) were evaluated by Joinpoint regression. Age, period, and birth cohort effects were assessed by age‐period‐cohort models. Results From 1973 to 2010, compared with long‐time slowly increasing trend in women, male lung cancer incidence had significantly decreased between 2001 and 2009. After that lung cancer incidence rising sharply in women (AAPC = 14.13%, 95%CI: 2.68%‐26.86%, P = .016) and similar rising trends without statistical significance in men (AAPC = 2.96, 95%CI: −2.47%‐8.69%, P = .281) between 2010 and 2014. Age‐period cohort model showed the different patterns of period effects for lung cancer incidence between men and women. The period effects for lung cancer incidence showed rising effect for women, whereas there was decline effect for lung cancer incidence for men. On the other hand, the model showed a significant period effect in both genders with a similar fashion in mortality, yielding steady falling trends during the entire study period. Conclusions The distinctive patterns of lung cancer incidence between men and women may be attributable to significant period effects, which reflected the changes in public health policies or diagnostic practices and highlighted the urgent of continued monitoring of gender‐specific risk factors for lung cancer incidence.
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Affiliation(s)
- Li Xie
- Hongqiao International Institute of MedicineShanghai Tong Ren Hospital and Clinical Research InstituteShanghai Jiao Tong University School of MedicineShanghaiPeople’s Republic of China
| | - Ying Qian
- Hongqiao International Institute of MedicineShanghai Tong Ren Hospital and Clinical Research InstituteShanghai Jiao Tong University School of MedicineShanghaiPeople’s Republic of China
- School of Public HealthShanghai Jiao Tong University School of MedicineShanghaiPeople’s Republic of China
| | - Yishan Liu
- Hongqiao International Institute of MedicineShanghai Tong Ren Hospital and Clinical Research InstituteShanghai Jiao Tong University School of MedicineShanghaiPeople’s Republic of China
- School of Public HealthShanghai Jiao Tong University School of MedicineShanghaiPeople’s Republic of China
| | - Yixuan Li
- Hongqiao International Institute of MedicineShanghai Tong Ren Hospital and Clinical Research InstituteShanghai Jiao Tong University School of MedicineShanghaiPeople’s Republic of China
| | - Sinong Jia
- Hongqiao International Institute of MedicineShanghai Tong Ren Hospital and Clinical Research InstituteShanghai Jiao Tong University School of MedicineShanghaiPeople’s Republic of China
- School of Public HealthShanghai Jiao Tong University School of MedicineShanghaiPeople’s Republic of China
| | - Herbert Yu
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterHonoluluHIUSA
| | - Chunfang Wang
- Shanghai Municipal Center for Disease Control and PreventionShanghaiPeople’s Republic of China
| | - Biyun Qian
- Hongqiao International Institute of MedicineShanghai Tong Ren Hospital and Clinical Research InstituteShanghai Jiao Tong University School of MedicineShanghaiPeople’s Republic of China
- School of Public HealthShanghai Jiao Tong University School of MedicineShanghaiPeople’s Republic of China
| | - Pingping Bao
- Shanghai Municipal Center for Disease Control and PreventionShanghaiPeople’s Republic of China
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Cowdery SP, Sajjad MA, Holloway-Kew KL, Mohebbi M, Williams LJ, Kotowicz MA, Livingston PM, Khasraw M, Hakkennes S, Dunning TL, Brumby S, Page RS, Sutherland AG, Brennan-Olsen SL, Berk M, Campbell D, Pasco JA. Mapping Cancer incidence across Western Victoria: the association with age, accessibility, and socioeconomic status among men and women. BMC Cancer 2019; 19:892. [PMID: 31492163 PMCID: PMC6728959 DOI: 10.1186/s12885-019-6070-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 08/21/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Cancer is a leading burden of disease in Australia and worldwide, with incidence rates varying with age, sex and geographic location. As part of the Ageing, Chronic Disease and Injury study, we aimed to map the incidence rates of primary cancer diagnoses across western Victoria and investigate the association of age, accessibility/remoteness index of Australia (ARIA) and area-level socioeconomic status (SES) with cancer incidence. METHODS Data on cancer incidence in the study region were extracted from the Victorian Cancer Registry (VCR) for men and women aged 40+ years during 2010-2013, inclusive. The age-adjusted incidence rates (per 10,000 population/year), as well as specific incidence for breast, prostate, lung, bowel and melanoma cancers, were calculated for the entire region and for the 21 Local Government Areas (LGA) that make up the whole region. The association of aggregated age, ARIA and SES with cancer incidence rates across LGAs was determined using Poisson regression. RESULTS Overall, 15,120 cancer cases were identified; 8218 (54%) men and 6902 women. For men, the age-standardised rate of cancer incidence for the whole region was 182.1 per 10,000 population/year (95% CI 177.7-186.5) and for women, 162.2 (95% CI: 157.9-166.5). The incidence of cancer (overall) increased with increasing age for men and women. Geographical variations in cancer incidence were also observed across the LGAs, with differences identified between men and women. Residents of socioeconomically disadvantaged and less accessible areas had higher cancer incidence (p < 0.001). CONCLUSION Cancer incidence rates varied by age, sex, across LGAs and with ARIA. These findings not only provide an evidence base for identifying gaps and assessing the need for services and resource allocation across this region, but also informs policy and assists health service planning and implementation of preventative intervention strategies to reduce the incidence of cancer across western Victoria. This study also provides a model for further research across other geographical locations with policy and clinical practice implications, both nationally and internationally.
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Affiliation(s)
| | | | | | - Mohammadreza Mohebbi
- Faculty of Health, Deakin University, Geelong, Australia.,Faculty of Health, Biostatistics Unit, Deakin University, Geelong, Australia
| | | | - Mark A Kotowicz
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia.,University Hospital Geelong, Barwon Health, Geelong, Australia
| | | | - Mustafa Khasraw
- School of Medicine, Deakin University, Geelong, Australia.,The University of Sydney, Sydney, Australia
| | | | - Trisha L Dunning
- Centre for Quality and Patient Safety Research, Barwon Health Partnership, School of Nursing and Midwifery, Deakin University Geelong, Hamilton, Australia
| | - Susan Brumby
- School of Medicine, Deakin University, Geelong, Australia.,National Centre for Farmer Health, Western District Health Service, Hamilton, Australia
| | - Richard S Page
- School of Medicine, Deakin University, Geelong, Australia.,University Hospital Geelong, Barwon Health, Geelong, Australia.,Barwon Centre for Orthopaedic Research and Education, Barwon Health and St John of God Hospitals, Geelong, Australia
| | - Alasdair G Sutherland
- School of Medicine, Deakin University, Geelong, Australia.,South West Healthcare, Warrnambool, Australia
| | - Sharon L Brennan-Olsen
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), St Albans, Australia
| | - Michael Berk
- School of Medicine, Deakin University, Geelong, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, St Albans, Australia.,Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - David Campbell
- University Hospital Geelong, Barwon Health, Geelong, Australia
| | - Julie A Pasco
- School of Medicine, Deakin University, Geelong, Australia.,Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia.,University Hospital Geelong, Barwon Health, Geelong, Australia.,Department of Epidemiology and Preventive Health, Monash University, Melbourne, Australia
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9
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Yu XQ, Luo Q, Kahn C, Cahill C, Weber M, Grogan P, Jemal A, O'Connell DL. Widening socioeconomic disparity in lung cancer incidence among men in New South Wales, Australia, 1987-2011. Chin J Cancer Res 2017; 29:395-401. [PMID: 29142458 DOI: 10.21147/j.issn.1000-9604.2017.05.03] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective We assessed the trends in lung cancer incidence over a 25-year period by socioeconomic groups for men in New South Wales (NSW), Australia. Methods Men diagnosed with lung cancer between 1987 and 2011 were divided into five quintiles according to an Index of Education and Occupation (IEO). We assessed relative socioeconomic differences over time by calculating age-standardized incidence ratios (SIRs) by 5-year period of diagnosis, and estimated absolute differences by comparing the observed and expected numbers of cases using the highest IEO quintile as the reference. Results Lung cancer incidence for men decreased from 1987 to 2011 for all IEO quintiles, with a greater rate of decline for men living in the highest IEO areas. Thus, the relative disparity increased significantly over the 25-year period (P=0.0006). For example, the SIR for the lowest IEO quintile increased from 1.28 during 1987-1991 to 1.74 during 2007-2011. Absolute differences also increased with the proportion of " potentially preventable" cases doubling from 14.5% in 1987-1991 to 30.2% in 2007-2011. Conclusions Despite the overall decline in lung cancer incidence among men in NSW over the past 25 years, there was a significant increase in disparity across socioeconomic areas in both relative and absolute terms.
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Affiliation(s)
- Xue Qin Yu
- Cancer Research Division, Cancer Council NSW, Sydney NSW 1340, Australia.,Sydney School of Public Health, University of Sydney, Sydney NSW 2006, Australia
| | - Qingwei Luo
- Cancer Research Division, Cancer Council NSW, Sydney NSW 1340, Australia.,Sydney School of Public Health, University of Sydney, Sydney NSW 2006, Australia
| | - Clare Kahn
- Cancer Research Division, Cancer Council NSW, Sydney NSW 1340, Australia
| | - Camilla Cahill
- Cancer Research Division, Cancer Council NSW, Sydney NSW 1340, Australia
| | - Marianne Weber
- Cancer Research Division, Cancer Council NSW, Sydney NSW 1340, Australia.,Sydney School of Public Health, University of Sydney, Sydney NSW 2006, Australia
| | - Paul Grogan
- Cancer Research Division, Cancer Council NSW, Sydney NSW 1340, Australia.,Sydney School of Public Health, University of Sydney, Sydney NSW 2006, Australia
| | - Ahmedin Jemal
- Cancer Research Division, Cancer Council NSW, Sydney NSW 1340, Australia
| | - Dianne L O'Connell
- Cancer Research Division, Cancer Council NSW, Sydney NSW 1340, Australia.,Sydney School of Public Health, University of Sydney, Sydney NSW 2006, Australia.,Sanofi Australia, Sydney NSW 2113, Australia
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