Estimation of the Potentially Avoidable Excess Deaths Associated with Socioeconomic Inequalities in Cancer Survival in Germany

Abstract

Many countries have reported survival inequalities due to regional socioeconomic deprivation. To quantify the potential gain from eliminating cancer survival disadvantages associated with area-based deprivation in Germany, we calculated the number of avoidable excess deaths. We used population-based cancer registry data from 11 of 16 German federal states. Patients aged ≥15 years diagnosed with an invasive malignant tumor between 2008 and 2017 were included. Area-based socioeconomic deprivation was assessed using the quintiles of the German Index of Multiple Deprivation (GIMD) 2010 on a municipality level nationwide. Five-year age-standardized relative survival for 25 most common cancer sites and for total cancer were calculated using period analysis. Incidence and number of avoidable excess deaths in Germany in 2013–2016 were estimated. Summed over the 25 cancer sites, 4100 annual excess deaths (3.0% of all excess deaths) could have been avoided each year in Germany during the period 2013–2016 if relative survival were in all regions comparable with the least deprived regions. Colorectal, oral and pharynx, prostate, and bladder cancer contributed the largest numbers of avoidable excess deaths. Our results provide a good basis to estimate the potential of intervention programs for reducing socioeconomic inequalities in cancer burden in Germany.

Socioeconomic disparities in endometrial cancer survival in Germany: a survival analysis using population-based cancer registry data

“…In a recent study by Finke et al, the majority of cancer patients living in the most socioeconomically deprived municipalities were found to have significantly lower survival compared to the most affluent patients in Germany (Finke et al 2021 ). These findings confirm the survival disparity reported in previous studies (Brenner et al 1991 ; Jansen et al 2014 , 2020 , 2021 ). In regard to EC, social deprivation could affect clinical outcomes on several levels from early pathogenesis to stage at diagnosis and treatment.…”

“…In Germany however, as of the writing of this paper, we were unable to find studies that dealt with this topic. Jansen et al ( 2021 ) measured the 5-year age standardized relative survival of women diagnosed with Corpus Uteri cancer, among other cancer sites, during the period between 2013 and 2017. The study was based on 200 administrative German districts representing approximately 39% of the entire population.…”

Disparities in quality of life, social distress and employment outcomes in Australian cancer survivors

“…A number of sociodemographic factors have been associated with variation in outcomes for cancer survivors. Cancer survival is known to vary by socio-economic advantage/disadvantage [6][7][8][9][10][11] with this difference partly explained by variations in stage at diagnosis and treatment differences [6]. Recent evidence suggests that psychosocial factors including living alone, being unmarried and higher levels of depression can also negatively impact survival [12,13].…”

Disparities in Cancer-Related Avoidable Mortality by the Level of Area Deprivation in South Korea

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