Background:
Reducing inequalities in cancer incidence and mortality is a key goal of the Improving Outcomes Strategy for Cancer. Risk factors, including smoking, diet, drinking and exercise, affect the rate of cancer between socio-economic groups.
Aim:
This study builds on previous reports of cancer incidence by deprivation, extending the period covered, range of sites and including cancer mortality.
Methods:
For 37 individual sites and all cancers combined, incidence (1996-2000, 2001-2005, 2006-2010) and mortality (2002-2006, 2007-2011; all cancers additionally including 1997-2001) in England were analysed by deprivation quintile. Statistical significance tests were performed on deprivation trends across quintiles and changes in trend over time. Where relevant, trend differences between sexes were tested. For statistically significant trends, excess cases and deaths were calculated.
Results:
If the more deprived had the same rates as the least deprived, there would have been around 15,300 fewer cases and 19,200 fewer deaths per year, for persons, across all cancers combined in the latest 5-year periods. Lung cancer dominates with around 11,700 excess cases and 9,900 excess deaths per year.
In the latest periods, for persons, 24 sites (65%) had statistically significant deprivation trends; of these, more deprived quintiles had higher rates in 19 sites for incidence and 23 for mortality. Some cancers (including breast, prostate and melanoma) showed inverse deprivation trends, with highest rates in the least deprived quintile.
Males had a greater association between deprivation and cancer than females in 7 sites, for incidence and mortality.
Deprivation trends of cancer incidence and mortality have not improved over time, with the gap reducing in 2 sites and increasing in 5 others, for incidence. Mortality saw no change.
Conclusions:
Inequalities have not reduced. These results can be used to identify areas for targeted interventions to improve outcomes for more deprived populations.
Acknowledgement: CRUK/NCIN partnership