Socioeconomic disparities in cancer incidence and mortality in England and the impact of age-at-diagnosis on cancer mortality
Socioeconomic disparities in cancer incidence and mortality in England and the impact of age-at-diagnosis on cancer mortality
Background: we identify socioeconomic disparities by region in cancer morbidity and mortality in England for all-cancer and type-specific cancers, and use incidence data to quantify the impact of cancer diagnosis delays on cancer deaths between 2001–2016.
Methods and findings: we obtain population cancer morbidity and mortality rates at various age, year, gender, deprivation, and region levels based on a Bayesian approach. A significant increase in type-specific cancer deaths, which can also vary among regions, is shown as a result of delay in cancer diagnoses. Our analysis suggests increase of 7.75% (7.42% to 8.25%) in female lung cancer mortality in London, as an impact of 12-month delay in cancer diagnosis, and a 3.39% (3.29% to 3.48%) increase in male lung cancer mortality across all regions. The same delay can cause a 23.56% (23.09% to 24.30%) increase in male bowel cancer mortality. Furthermore, for all-cancer mortality, the highest increase in deprivation gap happened in the East Midlands, from 199 (186 to 212) in 2001, to 239 (224 to 252) in 2016 for males, and from 114 (107 to 121) to 163 (155 to 171) for females. Also, for female lung cancer, the deprivation gap has widened with the highest change in the North West, e.g. for incidence from 180 (172 to 188) to 272 (261 to 282), whereas it has narrowed for prostate cancer incidence with the biggest reduction in the South West from 165 (139 to 190) in 2001 to 95 (72 to 117) in 2016.
Conclusions: the analysis reveals considerable disparities in all-cancer and some type-specific cancers with respect to socioeconomic status. Furthermore, a significant increase in cancer deaths is shown as a result of delays in cancer diagnoses which can be linked to concerns about the effect of delay in cancer screening and diagnosis during the COVID-19 pandemic. Public health interventions at regional and deprivation level can contribute to prevention of cancer deaths.
Arik, Ayse
7d54e4e9-c8df-46af-becc-3a7beb61a9b6
Dodd, Erengul
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Cairns, Andrew
27945b1c-4bb5-4b9c-9e4e-84ff6d590237
Streftaris, George
a941afc0-43f6-48d2-970d-3d8db7ca3ae4
14 July 2021
Arik, Ayse
7d54e4e9-c8df-46af-becc-3a7beb61a9b6
Dodd, Erengul
b3faed76-f22b-4928-a922-7f0b8439030d
Cairns, Andrew
27945b1c-4bb5-4b9c-9e4e-84ff6d590237
Streftaris, George
a941afc0-43f6-48d2-970d-3d8db7ca3ae4
Arik, Ayse, Dodd, Erengul, Cairns, Andrew and Streftaris, George
(2021)
Socioeconomic disparities in cancer incidence and mortality in England and the impact of age-at-diagnosis on cancer mortality.
PLoS ONE, 16 (7 July), [e0253854].
(doi:10.1371/journal.pone.0253854).
Abstract
Background: we identify socioeconomic disparities by region in cancer morbidity and mortality in England for all-cancer and type-specific cancers, and use incidence data to quantify the impact of cancer diagnosis delays on cancer deaths between 2001–2016.
Methods and findings: we obtain population cancer morbidity and mortality rates at various age, year, gender, deprivation, and region levels based on a Bayesian approach. A significant increase in type-specific cancer deaths, which can also vary among regions, is shown as a result of delay in cancer diagnoses. Our analysis suggests increase of 7.75% (7.42% to 8.25%) in female lung cancer mortality in London, as an impact of 12-month delay in cancer diagnosis, and a 3.39% (3.29% to 3.48%) increase in male lung cancer mortality across all regions. The same delay can cause a 23.56% (23.09% to 24.30%) increase in male bowel cancer mortality. Furthermore, for all-cancer mortality, the highest increase in deprivation gap happened in the East Midlands, from 199 (186 to 212) in 2001, to 239 (224 to 252) in 2016 for males, and from 114 (107 to 121) to 163 (155 to 171) for females. Also, for female lung cancer, the deprivation gap has widened with the highest change in the North West, e.g. for incidence from 180 (172 to 188) to 272 (261 to 282), whereas it has narrowed for prostate cancer incidence with the biggest reduction in the South West from 165 (139 to 190) in 2001 to 95 (72 to 117) in 2016.
Conclusions: the analysis reveals considerable disparities in all-cancer and some type-specific cancers with respect to socioeconomic status. Furthermore, a significant increase in cancer deaths is shown as a result of delays in cancer diagnoses which can be linked to concerns about the effect of delay in cancer screening and diagnosis during the COVID-19 pandemic. Public health interventions at regional and deprivation level can contribute to prevention of cancer deaths.
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journal.pone.0253854
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Accepted/In Press date: 15 June 2021
Published date: 14 July 2021
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© 2021 Arik et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Local EPrints ID: 450582
URI: http://eprints.soton.ac.uk/id/eprint/450582
ISSN: 1932-6203
PURE UUID: e12f55e9-3e86-4517-81ba-e19880da012c
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Date deposited: 04 Aug 2021 16:34
Last modified: 17 Mar 2024 03:34
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Author:
Ayse Arik
Author:
Andrew Cairns
Author:
George Streftaris
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