Socio-economic inequalities in lung cancer mortality in Spain: a nation-wide study using area-based deprivation

International Journal for Equity in Health

Research

Olivier Nuñez¹  Pablo Fernández-Navarro¹  Juan Manuel García-Torrecillas²  Miguel Rodríguez-Barranco³  María-José Sánchez³  Daniel Redondo-Sánchez³  Dafina Petrova³  Jose Juan Jiménez-Moleón⁴ 

[1] CIBER of Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain;Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, 28029, Madrid, Spain;Instituto de Investigación Biosanitaria ibs.GRANADA, 18012, Granada, Spain;CIBER of Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain;Emergency and Research Unit, Torrecárdenas University Hospital, 04009, Almería, Spain;Instituto de Investigación Biosanitaria ibs.GRANADA, 18012, Granada, Spain;CIBER of Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain;Escuela Andaluza de Salud Pública, 18080, Granada, Spain;Instituto de Investigación Biosanitaria ibs.GRANADA, 18012, Granada, Spain;Department of Preventive Medicine and Public Health, University of Granada, 18071, Granada, Spain;

关键词: Cancer;    Lung cancer;    Mortality;    Health inequities;    Socioeconomic disparities in health;   

DOI  :  10.1186/s12939-023-01970-y

 received in 2023-05-07, accepted in 2023-07-19,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundLung cancer is the main cause of cancer mortality worldwide and in Spain. Several previous studies have documented socio-economic inequalities in lung cancer mortality but these have focused on specific provinces or cities. The goal of this study was to describe lung cancer mortality in Spain by sex as a function of socio-economic deprivation.MethodsWe analysed all registered deaths from lung cancer during the period 2011–2017 in Spain. Mortality data was obtained from the National Institute of Statistics, and socio-economic level was measured with the small-area deprivation index developed by the Spanish Society of Epidemiology, with the census tract of residence at the time of death as the unit of analysis. We computed crude and age-standardized rates per 100,000 inhabitants by sex, deprivation quintile, and type of municipality (rural, semi-rural, urban) considering the 2013 European standard population (ASR-E). We further calculated ASR-E ratios between the most deprived (Q5) and the least deprived (Q1) areas and mapped census tract smoothed standardized lung cancer mortality ratios by sex.ResultsWe observed 148,425 lung cancer deaths (80.7% in men), with 73.5 deaths per 100,000 men and 17.1 deaths per 100,000 women. Deaths from lung cancer in men were five times more frequent than in women (ASR-E ratio = 5.3). Women residing in the least deprived areas had higher mortality from lung cancer (ASR-E = 22.2), compared to women residing in the most deprived areas (ASR-E = 13.2), with a clear gradient among the quintiles of deprivation. For men, this pattern was reversed, with the highest mortality occurring in areas of lower socio-economic level (ASR-E = 99.0 in Q5 vs. ASR-E = 86.6 in Q1). These socio-economic inequalities remained fairly stable over time and across urban and rural areas.ConclusionsSocio-economic status is strongly related to lung cancer mortality, showing opposite patterns in men and women, such that mortality is highest in women residing in the least deprived areas and men residing in the most deprived areas. Systematic surveillance of lung cancer mortality by socio-economic status may facilitate the assessment of public health interventions aimed at mitigating cancer inequalities in Spain.

【 授权许可】

CC BY   
© The Author(s) 2023

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