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. 2021 Feb 24;13(5):933.
doi: 10.3390/cancers13050933.

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

Michael Rosskamp  1 , Julie Verbeeck  1 , Sylvie Gadeyne  2 , Freija Verdoodt  1 , Harlinde De Schutter  1
Affiliations

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

Michael Rosskamp et al. Cancers (Basel). .

Abstract

Background: Socio-economic position is associated with cancer incidence, but the direction and magnitude of this relationship differs across cancer types, geographical regions, and socio-economic parameters. In this nationwide cohort study, we evaluated the association between different individual-level socio-economic and -demographic factors, cancer incidence, and stage at diagnosis in Belgium. Methods: The 2001 census was linked to the nationwide Belgian Cancer Registry for cancer diagnoses between 2004 and 2013. Socio-economic parameters included education level, household composition, and housing conditions. Incidence rate ratios were assessed through Poisson regression models. Stage-specific analyses were conducted through logistic regression models. Results: Deprived groups showed higher risks for lung cancer and head and neck cancers, whereas an inverse relation was observed for malignant melanoma and female breast cancer. Typically, associations were more pronounced in men than in women. A lower socio-economic position was associated with reduced chances of being diagnosed with known or early stage at diagnosis; the strongest disparities were found for male lung cancer and female breast cancer. Conclusions: This study identified population groups at increased risk of cancer and unknown or advanced stage at diagnosis in Belgium. Further investigation is needed to build a comprehensive picture of socio-economic inequality in cancer incidence.

Keywords: cancer incidence; cancer stage; census; nationwide cohort study; socio-economic position.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Adjusted incidence rate ratios (IRRs) with a 95% confidence interval (CI) by socio-economic (SE) or -demographic (SD) parameters, cancer type, and sex; 2004–2013. Upper panel (a): men; lower panel (b): women.
Figure 2
Figure 2
Adjusted odds ratios (ORs) with a 95% confidence interval (CI) for being diagnosed with unknown stage by socio-economic (SE) or -demographic (SD) parameters, cancer type, and sex; 2004–2013. Upper panel (a): men; lower panel (b): women.
Figure 3
Figure 3
Adjusted odds ratios (ORs) with a 95% confidence interval (CI) for being diagnosed with advanced stage among known stages by socio-economic (SE) or -demographic (SD) parameters, cancer type, and sex; 2004–2013. Upper panel (a): men; lower panel (b): women.
See this image and copyright information in PMC

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