Population-based incidence trends of oropharyngeal and oral cavity cancers by sex among the poorest and underprivileged populations

BMC Cancer

Ajit Auluck¹  Blake Byron Walker³  Greg Hislop¹  Scott A Lear²  Nadine Schuurman³  Miriam Rosin¹ 

[1] Cancer Control Research Department, BC Cancer Agency, Research Centre, 675 W. 10th Ave, 3rd Floor, Room 119, V5Z1L3 Vancouver, B.C, Canada

[2] Division of Cardiology, Providence Health Care, St. Paul’s Hospital, Vancouver, Canada

[3] Department of Geography, Simon Fraser University, Burnaby, BC, Canada

关键词: Socioeconomic deprivation;    Incidence;    Oropharyngeal cancer;    Oral cavity cancer;    HPV infection;   

Others  :  858842
DOI  :  10.1186/1471-2407-14-316

 received in 2014-01-07, accepted in 2014-04-22,  发布年份 2014

【 摘 要 】

Background

Oral cancer is an important health issue, with changing incidence in many countries. Oropharyngeal cancer (OPC, in tonsil and oropharygeal areas) is increasing, while oral cavity cancer (OCC, other sites in the mouth) is decreasing. There is the need to identify high risk groups and communities for further study and intervention. The objective of this study was to determine how the incidence of OPC and OCC varied by neighbourhood socioeconomic status (SES) in British Columbia (BC), including the magnitude of any inequalities and temporal trends.

Methods

ICDO-3 codes were used to identify OPC and OCC cases in the BC Cancer Registry from 1981–2010. Cases were categorized by postal codes into SES quintiles (q1-q5) using VANDIX, which is a census-based, multivariate weighted index based on neighbourhood average household income, housing tenure, educational attainment, employment and family structure. Age-standardized incidence rates were determined for OPC and OCC by sex and SES quintiles and temporal trends were then examined.

Results

Incidence rates are increasing in both men and women for OPC, and decreasing in men and increasing in women for OCC. This change is not linear or proportionate between different SES quintiles, for there is a sharp and dramatic increase in incidence according to the deprivation status of the neighbourhood. The highest incidence rates in men for both OPC and OCC were observed in the most deprived SES quintile (q5), at 1.7 times and 2.2 times higher, respectively, than men in the least deprived quintile (q1). For OPC, the age-adjusted incidence rates significantly increased in all SES quintiles with the highest increase observed in the most deprived quintile (q5). Likewise, the highest incidence rates for both OPC and OCC in women were observed in the most deprived SES quintile (q5), at 2.1 times and 1.8 times higher, respectively, than women in the least deprived quintile (q1).

Conclusion

We report on SES disparities in oral cancer, emphasizing the need for community-based interventions that address access to medical care and the distribution of educational and health promotion resources among the most SES deprived communities in British Columbia.

【 授权许可】

   
2014 Auluck et al.; licensee BioMed Central Ltd.

【 图 表 】

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