Socio-economic inequalities in lung cancer mortality in Spain: a nation-wide study using area-based deprivation
Metadatos
Mostrar el registro completo del ítemEditorial
BMC
Materia
Cancer Lung cancer Mortality Health inequities Socioeconomic disparities in health
Fecha
2023-08-02Referencia bibliográfica
Redondo-Sánchez, D., Fernández-Navarro, P., Rodríguez-Barranco, M. et al. Socio-economic inequalities in lung cancer mortality in Spain: a nation-wide study using area-based deprivation. Int J Equity Health 22, 145 (2023). [https://doi.org/10.1186/s12939-023-01970-y]
Patrocinador
High Resolution Study of Social Inequalities in Cancer (HiReSIC); Asociacion Espanola Contra el Cancer (AECC) PROYE20023SANC; Subprograma de Vigilancia Epidemiologica del Cancer (VICA); CIBER de Epidemiologia y Salud Publica (CIBERESP); Instituto de Salud Carlos III Spanish Government PI18/01593; Juan de la Cierva Fellowship from the Ministry of Science; National Research Agency of Spain (MCIN/AEI) JC2019-039691-I; National Statistics Institute (INE) BE099-2021Resumen
Background Lung cancer is the main cause of cancer mortality worldwide and in Spain. Several previous studies
have documented socio-economic inequalities in lung cancer mortality but these have focused on specific provinces
or cities. The goal of this study was to describe lung cancer mortality in Spain by sex as a function of socio-economic
deprivation.
Methods We analysed all registered deaths from lung cancer during the period 2011–2017 in Spain. Mortality data
was obtained from the National Institute of Statistics, and socio-economic level was measured with the small-area
deprivation index developed by the Spanish Society of Epidemiology, with the census tract of residence at the
time of death as the unit of analysis. We computed crude and age-standardized rates per 100,000 inhabitants by
sex, deprivation quintile, and type of municipality (rural, semi-rural, urban) considering the 2013 European standard
population (ASR-E). We further calculated ASR-E ratios between the most deprived (Q5) and the least deprived (Q1)
areas and mapped census tract smoothed standardized lung cancer mortality ratios by sex.
Results We observed 148,425 lung cancer deaths (80.7% in men), with 73.5 deaths per 100,000 men and 17.1
deaths per 100,000 women. Deaths from lung cancer in men were five times more frequent than in women (ASR-E
ratio = 5.3). Women residing in the least deprived areas had higher mortality from lung cancer (ASR-E = 22.2),
compared to women residing in the most deprived areas (ASR-E = 13.2), with a clear gradient among the quintiles of
deprivation. For men, this pattern was reversed, with the highest mortality occurring in areas of lower socio-economic
level (ASR-E = 99.0 in Q5 vs. ASR-E = 86.6 in Q1). These socio-economic inequalities remained fairly stable over time
and across urban and rural areas.
Conclusions Socio-economic status is strongly related to lung cancer mortality, showing opposite patterns in men
and women, such that mortality is highest in women residing in the least deprived areas and men residing in the
most deprived areas. Systematic surveillance of lung cancer mortality by socio-economic status may facilitate the
assessment of public health interventions aimed at mitigating cancer inequalities in Spain.