Social inequalities in cancer within countries
Socioeconomic inequalities in cancer incidence, survival, and mortality have been reported from all high-income countries in which information on education level, occupational class, income, or other indicators of socioeconomic status is available and has been investigated in relation to cancer, as recorded in cancer or cause-of-death registries. These associations are subject to substantial variability, not only across the different cancer types but also between countries and over time. The graphs below show mortality rates for men (left) and women (right) with a low (left) and high (right) education level.
Trends of age-standardized all-cancer mortality rates (European Standard Population) in deaths per 100 000 person-years in 17 European countries, using data from 1990–2012.
Age−standardized mortality rate
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Cancer mortality among high education level groups of men and women has almost universally declined, but trends in cancer mortality over the past decades have generally been more favourable among high education level groups than among low education level groups, for which cancer mortality rates have often remained stable or even increased. Disadvantaged individuals and groups tend to have a different spectrum of cancers compared with people with higher SES, notably an excess of tobacco-related and infection-related cancers.
The variability of inequalities in cancer incidence and mortality, both between countries and over time, is a major public health challenge. This variability clearly suggests that these inequalities are not based on immutable laws of nature but are potentially modifiable.
- Vaccarella S, Lortet-Tieulent J, Saracci R, Conway DI, Straif K, Wild CP, editors (2019). Reducing social inequalities in cancer: evidence and priorities for research (IARC Scientific Publication No. 168). Lyon, France: International Agency for Research on Cancer. Available from: http://publications.iarc.fr/580.