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

Abstract

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.

Socioeconomic environment and disparities in cancer survival for 19 solid tumor sites: An analysis of the French Network of Cancer Registries (FRANCIM) data

“…Previous studies investigating the influence of social environment on cancer survival for several solid tumor sites with comparable methodology (i.e. population‐based registries data, ecological deprivation index, net survival) also showed lower survival among patients living in the most deprived environments compared to those living in the least deprived ones, for most cancer sites . More broadly, all studies investigating social inequalities in cancer survival worldwide have reported lower survival among the most deprived for a large majority of cancer sites, with no significant inverse association .…”

“…Moreover, we used a validated indicator for social deprivation, developed and used in several European countries . The EDI offers an acceptable approximation of social deprivation at the individual level when used in small geographic units such as IRIS, while also providing information on the social environment, known to have a proper effect on cancer survival for some cancer sites . The measure of the variation of survival between the least and the most deprived quintiles brought new information on the extent of survival disparities according to social deprivation that can be compared across cancer sites or different times of follow‐up since it is a relative measure of the deprivation gap.…”

“…However, some of the potential explanations mentioned above as well as previous research suggest that not only individual but also contextual and environmental factors might contribute to social inequalities in cancer survival. Indeed, several population‐based studies from different countries have shown that patients living in the most deprived areas experienced lower survival rates than those living in the most affluent ones, for most of the cancer sites …”

Optimization of Ultrasound-Assisted Extraction of Flavonoids from Celastrus hindsii Leaves Using Response Surface Methodology and Evaluation of Their Antioxidant and Antitumor Activities

“…Cancer is a major health issue, which is ranked as a leading cause of mortality worldwide [1,2]. To treat cancer, chemotherapy is one of the most commonly used therapeutic methods as it is the most effective approach [3].…”

Study on Population Distribution Pattern at the County Level of China

“…In the 1970s, Western scholars began to pay attention to the suburbanization of the urban population. The research focused mainly on the changes in population distribution [9,10], the relationship between population density changes and social phenomena [11][12][13], population suburbanization and spatial structure [14,15] and so on.…”