Site-specific cancer mortality inequalities by employment and occupational groups: a cohort study among Belgian adults, 2001–2011

Abstract

ObjectiveThis study probes into site-specific cancer mortality inequalities by employment and occupational group among Belgians, adjusted for other indicators of socioeconomic (SE) position.DesignThis cohort study is based on record linkage between the Belgian censuses of 1991 and 2001 and register data on emigration and mortality for 01/10/2001 to 31/12/2011.SettingBelgium.ParticipantsThe study population contains all Belgians within the economically active age (25–65 years) at the census of 1991.Outcome measuresBoth absolute and relative measures were calculated. First, age-standardised mortality rates have been calculated, directly standardised to the Belgian population. Second, mortality rate ratios were calculated using Poisson’s regression, adjusted for education, housing conditions, attained age, region and migrant background.ResultsThis study highlights inequalities in site-specific cancer mortality, both related to being employed or not and to the occupational group of the employed population. Unemployed men and women show consistently higher overall and site-specific cancer mortality compared with the employed group. Also within the employed group, inequalities are observed by occupational group. Generally manual workers and service and sales workers have higher site-specific cancer mortality rates compared with white-collar workers and agricultural and fishery workers. These inequalities are manifest for almost all preventable cancer sites, especially those cancer sites related to alcohol and smoking such as cancers of the lung, oesophagus and head and neck. Overall, occupational inequalities were less pronounced among women compared with men.ConclusionsImportant SE inequalities in site-specific cancer mortality were observed by employment and occupational group. Ensuring financial security for the unemployed is a key issue in this regard. Future studies could also take a look at other working regimes, for instance temporary employment or part-time employment and their relation to health.

Compression, expansion, or maybe both? Growing inequalities in lung cancer in Germany

“…With respect to the reported time trends in life years free of LC and after morbidity onset changes in mortality after LC incidence played only a minor role since mortality rates remained largely stable over time. However, some studies report social inequalities in mortality after LC diagnosis [ 28 , 45 , 46 ], which were also evident for men and women below age 65 in our study (see S2 Fig ). While previous research based on a linkage of German cancer registry data and information on the regional deprivation level reported SES inequalities in LC incidence for men but not for women [ 9 ], we also found substantial inequalities among the female population.…”

Neighbourhood migrant composition and tobacco-related cancer mortality: A census-linked study among five origin groups in urban Belgium

“…concentrated areas seems more related to socio-economic circumstances than social capital. The fact that we observe this for men, but not women, seems to correspond to other studies demonstrating that risk behaviour such as tobacco and alcohol consumption and their related mortality are more strongly related to SEP among men than women (Vanthomme et al, 2016(Vanthomme et al, , 2017Williams et al, 2012). For Turkish men, the detrimental effect persisted upon adjustment but no effects were found for women.…”

Socio-Economic Position, Cancer Incidence and Stage at Diagnosis: A Nationwide Cohort Study in Belgium

“…In Belgium, so far, most studies have focused on the impact of SEP on cancer mortality [ 16 , 17 , 18 , 19 ]. However, mortality results from incidence and survival, both important epidemiological measures of cancer burden [ 20 ].…”