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Open Access Highly Accessed Research article

Socioeconomic environment and cancer incidence: a French population-based study in Normandy

Josephine Bryere1*, Olivier Dejardin126, Veronique Bouvier126, Marc Colonna3, Anne-Valérie Guizard146, Xavier Troussard126, Carole Pornet12, Françoise Galateau-Salle126, Simona Bara156, Ludivine Launay1, Lydia Guittet12 and Guy Launoy126

Author Affiliations

1 U1086 INSERM Cancers & Preventions, Avenue du Général Harris, Caen 14076, France

2 CHU, Avenue de la Côte de Nacre, Caen 14000, France

3 Isere cancer registry, CHU, Grenoble, France

4 CRLCC, Avenue du Général Harris, Caen 14076, France

5 Public hospital, rue Trottebec, Cherbourg 50100, France

6 Federation of cancer registries of Basse-Normandie, Caen, France

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BMC Cancer 2014, 14:87  doi:10.1186/1471-2407-14-87

Published: 13 February 2014

Abstract

Background

The struggle against social inequalities is a priority for many international organizations. The objective of the study was to quantify the cancer burden related to social deprivation by identifying the cancer sites linked to socioeconomic status and measuring the proportion of cases associated with social deprivation.

Methods

The study population comprised 68 967 cases of cancer diagnosed between 1997 and 2009 in Normandy and collected by the local registries. The social environment was assessed at an aggregated level using the European Deprivation Index (EDI). The association between incidence and socioeconomic status was assessed by a Bayesian Poisson model and the excess of cases was calculated with the Population Attributable Fraction (PAF).

Results

For lung, lips-mouth-pharynx and unknown primary sites, a higher incidence in deprived was observed for both sexes. The same trend was observed in males for bladder, liver, esophagus, larynx, central nervous system and gall-bladder and in females for cervix uteri. The largest part of the incidence associated with deprivation was found for cancer of gall-bladder (30.1%), lips-mouth-pharynx (26.0%), larynx (23.2%) and esophagus (19.6%) in males and for unknown primary sites (18.0%) and lips-mouth-pharynx (12.7%) in females. For prostate cancer and melanoma in males, the sites where incidence increased with affluence, the part associated with affluence was respectively 9.6% and 14.0%.

Conclusions

Beyond identifying cancer sites the most associated with social deprivation, this kind of study points to health care policies that could be undertaken to reduce social inequalities.

Keywords:
Cancer incidence; Socioeconomic inequalities; Registries; Population attributable fraction