German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany.
Prev Med. 2011 Oct;53(4-5):328-30. doi: 10.1016/j.ypmed.2011.07.021. Epub 2011 Aug 5.
Previous research from other countries shows a positive association between cancer risk and regional deprivation. This study explores this association for lung and colorectal cancers in Germany.
Regional deprivation was assessed by the 'Bavarian Index of Multiple Deprivation'. Cancer data were provided by the Cancer Registry of Bavaria (2003-2006). The association between cancer risk and regional deprivation was evaluated by multilevel Poisson regression analysis.
Crude incidence and mortality rates (per 1000 people) in the least deprived areas were 1.46 and 0.92 for lung cancer, 2.82 and 0.69 for colorectal cancer. For lung cancer, the age-adjusted relative risk (RR) for incidence in the most deprived districts (compared with the least deprived) in men was 1.41 (95% CI: 1.28-1.54), for mortality 1.59 (95% CI: 1.40-1.80); in women, an elevated RR was seen for mortality (1.24, 95% CI: 1.06-1.46). For colorectal cancer, the RR for incidence (men: 1.31, 95% CI: 1.17-1.46; women: 1.25, 95% CI: 1.12-1.40) and mortality (men: 1.51, 95% CI: 1.28-1.80; women: 1.49, 95% CI: 1.26-1.77) was always highest in the most deprived districts.
At the district level in Bavaria, the risk for lung and colorectal cancers mostly increases with increasing regional deprivation.
来自其他国家的先前研究表明,癌症风险与地区贫困之间存在正相关关系。本研究探讨了德国肺癌和结直肠癌的这种相关性。
通过“巴伐利亚多维度贫困指数”评估地区贫困程度。癌症数据由巴伐利亚癌症登记处(2003-2006 年)提供。通过多水平泊松回归分析评估癌症风险与地区贫困之间的关系。
在最贫困地区,肺癌的粗发病率和死亡率(每千人)分别为 1.46 和 0.92;结直肠癌分别为 2.82 和 0.69。对于男性肺癌,最贫困地区(与最贫困地区相比)的发病率调整相对风险(RR)为 1.41(95%CI:1.28-1.54),死亡率为 1.59(95%CI:1.40-1.80);女性死亡率升高,RR 为 1.24(95%CI:1.06-1.46)。对于结直肠癌,发病率的 RR(男性:1.31,95%CI:1.17-1.46;女性:1.25,95%CI:1.12-1.40)和死亡率(男性:1.51,95%CI:1.28-1.80;女性:1.49,95%CI:1.26-1.77)在最贫困地区始终最高。
在巴伐利亚的地区层面上,肺癌和结直肠癌的风险大多随着地区贫困程度的增加而增加。