Abstract
Archived Content
Information identified as archived is provided for reference, research or recordkeeping purposes. It is not subject to the Government of Canada Web Standards and has not been altered or updated since it was archived. Please "contact us" to request a format other than those available.
Background
Keywords
Findings
Authors
What is already known on this subject?
What does this study add?
Background
The risk of lung cancer has been shown to be inversely related to socioeconomic status (SES). Because the Canadian Cancer Registry does not contain socioeconomic data, the 1991 Canadian Census Cohort was used to study social determinants of lung cancer risk in the general Canadian population.
Data and methods
This study examines incidence rates of lung cancer and histologic subtypes by educational attainment, income and occupation in a broadly representative sample of Canadians aged 25 or older. Data for the 1991 Canadian Census Cohort were analyzed. The cohort comprised 2,734,835 individuals, among whom 215,700 new cancer cases were diagnosed from 1991 through 2003. Age-standardized incidence rates were calculated by age, sex, and SES using the direct method. Rate ratios, rate differences, and excess incidence were also calculated.
Results
An inverse risk between lung cancer incidence and educational attainment, income and occupation emerged among men and women, and a stepped negative gradient in RRs was evident for all SES variables and age groups. If all cohort members had experienced the rate of those with a university degree, lung cancer incidence would have been 56% lower in men and 55% lower in women. If all cohort members had experienced the incidence rate of those in the highest income quintile, incidence would have been 33% lower in men and 25% lower in women. If all cohort members had experienced the rate of those in managerial occupations, incidence would have been 54% lower in men and 44% lower in women.
Interpretation
A negative gradient in lung cancer risk was evident for all SES variables studied.
Keywords
Age-standardized incidence rates, longitudinal study, lung cancer, record linkage, social determinants of health, socioeconomic inequalities
Findings
Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer death in Canada, with an estimated 26,100 new cases and 20,500 deaths in 2014. Research consistently shows that lung cancer risk is inversely associated with socioeconomic status (SES). [Full Text]
Authors
Debjani Mitra (debjani.mitra@phac-aspc.gc.ca) and Amanda Shaw are with the Chronic Disease Surveillance Division at the Public Health Agency of Canada. Michael Tjepkema is with the Health Analysis Division at Statistics Canada. Paul Peters is with the Departments of Sociology and Economics at the University of New Brunswick.
What is already known on this subject?
- Studies have consistently shown that the risk of lung cancer is inversely related to socioeconomic status (SES).
- Because the Canadian Cancer Registry does not contain information on individual-level socioeconomic position, lung cancer risk cannot be studied directly by individual measures of SES.
- Recently, a large, representative sample of Canadians aged 25 or older—the 1991 Census Cohort—was linked to 13 years of cancer data.
What does this study adds?
- Data from the Canadian Census Cohort showed that that lung cancer risk was inversely associated with education, income and occupation in men and women.
- Education emerged as the SES indicator most strongly associated with lung cancer risk.
- Larger inequalities in lung cancer risk were evident for histologies more strongly associated with smoking.
- Date modified: