Neighborhood Deprivation and Lung Cancer Incidence and Mortality: A Multilevel Analysis from Sweden

Li, Xinjun; Sundquist, Jan; Zöller, Bengt; Sundquist, Kristina

doi:10.1097/jto.0000000000000417

Cited by 51 publications

(41 citation statements)

References 45 publications

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“…Of the cancer sites included in our study, lung cancer mortality showed the strongest association with neighborhood deprivation. This is in line with other studies that have found a strong association between area deprivation and lung cancer mortality and incidence, although some studies did not find any association . American studies have found higher colorectal cancer mortality and incidence in deprived areas, while colorectal cancer mortality was lower in high‐income areas .…”

Section: Discussionsupporting

confidence: 90%

“…Despite these limitations, our study overcomes many of the issues pointed out by previous studies . The large population based dataset allows us to look beyond all‐cancer mortality and to explore the association between individual and neighborhood deprivation and mortality for specific cancer sites while maintaining sufficient statistical power.…”

Section: Discussionmentioning

confidence: 99%

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Socioeconomic position, population density and site‐specific cancer mortality: A multilevel analysis of Belgian adults, 2001–2011

Hagedoorn

Vandenheede

Vanthomme

et al. 2017

Intl Journal of Cancer

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Our study explores the association between individual and neighborhood socioeconomic position (SEP) and all-cancer and site-specific cancer mortality. Data on all Belgian residents are retrieved from a population-based dataset constructed from the 2001 census linked to register data on emigration and mortality for [2001][2002][2003][2004][2005][2006][2007][2008][2009][2010][2011]. The study population contains all men and women aged 40 years or older during follow-up. Individual SEP is measured using education, employment status and housing conditions. Neighborhood SEP is measured by a deprivation index (in quintiles). Directly age-standardized mortality rates and multilevel Poisson models are used to estimate the association between individual SEP and neighborhood deprivation and mortality from all-cancer and cancer of the lung, colon and rectum, pancreas, prostate and female breast. The potential confounding role of population density is assessed using multilevel models as well. Our findings show an increase in mortality from all-cancer and site-specific cancer by decreasing level of individual SEP for both men and women. In addition, individuals living in highly deprived neighborhoods experience significantly higher mortality from all-cancer, lung cancer, pancreatic cancer and female colorectal cancer after controlling for individual SEP. Male colorectal and prostate cancer and female breast cancer are not associated with neighborhood deprivation. Population density acts as a confounder for female lung cancer only. Our study indicates that deprivation at both the individual and neighborhood level is associated with all-cancer mortality and mortality from several cancer sites. More research into the role of life-style related and clinical factors is necessary to gain more insight into causal pathway.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Socioeconomic position, population density and site‐specific cancer mortality: A multilevel analysis of Belgian adults, 2001–2011

Hagedoorn

Vandenheede

Vanthomme

et al. 2017

Intl Journal of Cancer

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“…It supports prior findings in developed countries that higher cancer prevalence is more likely to occur in highly deprived places (Anne et al 2011;Cramb et al 2012;Erhunmwunsee et al 2012;Hystad et al 2013). For example, area deprivation is associated with lung cancer incidence in Sweden (Li et al 2015) and Canada (Hystad et al 2013). Colorectal and lung cancer risks increase with area deprivation at district level in Bavaria (Kuznetsov et al 2011).…”

Section: Discussionsupporting

confidence: 82%

“…The inequities in cancer prevalence or survival associated with deprivation are not limited to the extreme ends of individual level (Erhunmwunsee et al 2012). Researchers argue that population within one neighborhood shares similar norms settings, healthcare resources and socioeconomic environment, and consequently they possibly shape a common level of disease risk and health status beyond individual characteristics (Havard et al 2008;Li et al 2015). Recent literature frequently designs area level deprivation index to health resource allocation and care planning (Havard et al 2008;Kuznetsov et al 2011;Robert et al 2012).…”

Section: Introductionmentioning

confidence: 95%

“…It is expected that annual new cancer cases will reach 17 million by 2020 and 11 million will occur in developing countries (Murray and López 1996). Moreover, poor people in developing countries are more vulnerable to cancer problems, given the higher frequency of exposure to risk factors and less accessibility to affordable care (Li et al 2015). The survival rate of cancer in these regions is estimated to be 55 % of that in developed countries (GLOBOCAN 2012).…”

Section: Introductionmentioning

confidence: 99%

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Area Deprivation and Liver Cancer Prevalence in Shenzhen, China: A Spatial Approach Based on Social Indicators

Wang

Tan

et al. 2016

Soc Indic Res

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Cancer has become an alarming threat to human health and well-being worldwide. Examining the social determinants of cancer prevalence should effectively inform the practices and strategies on cancer treatment and prevention. However, rather few studies have conducted in this regard for developing countries. This paper attempts to characterize the association between area deprivation and liver cancer prevalence using a case of Shenzhen, China. Data from 2009 to 2011 provided by Shenzhen's Health Information Center are used to calculate the incidence rate of liver cancer at district level. An area deprivation index (ADI) at district level is established by integrating 13 indicators of 5 domains (income, employment, education, housing and demography). The weight for each indicator is determined by two typical subjective methods (AHP and fuzzy AHP) and two common objective methods (Entropy and Coefficient Variation). Quantitative comparisons indicate that the four methods are highly consistent though they assign different weight to the indicators. Spatial lag regression identifies significantly positive linear relationships between ADIs and liver cancer incidence rate from 2009 and 2010. It suggests that greater possibility of liver cancer prevalence would be expected in districts of higher social deprivation. The results also denote that the obtained relationships are insensitive to weight determination method and temporal dimension. Our study demonstrates that spatial autocorrelation should be incorporated for better understanding the association between area deprivation and liver cancer prevalence at district level. This paper provides some new insights into social indicators research.

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Ethnicity, Geographic Location, and Cancer

Zhang¹

2017

Translational Toxicology and Therapeutics: Windows of Developmental Susceptibility in Reproduction and Cancer

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Neighborhood Deprivation and Lung Cancer Incidence and Mortality: A Multilevel Analysis from Sweden

Abstract: Results suggest that neighborhood deprivation is associated with incident and mortality cases of lung cancer in Sweden, independently of individual-level characteristics.

Cited by 51 publications

References 45 publications

Socioeconomic position, population density and site‐specific cancer mortality: A multilevel analysis of Belgian adults, 2001–2011

Socioeconomic position, population density and site‐specific cancer mortality: A multilevel analysis of Belgian adults, 2001–2011

Area Deprivation and Liver Cancer Prevalence in Shenzhen, China: A Spatial Approach Based on Social Indicators

Ethnicity, Geographic Location, and Cancer

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