Jansen Lina, Kanbach Josephine, Finke Isabelle, Arndt Volker, Emrich Katharina, Holleczek Bernd, Kajüter Hiltraud, Kieschke Joachim, Maier Werner, Pritzkuleit Ron, Sirri Eunice, Schwettmann Lars, Erb Cynthia, Brenner Hermann, Group For The German Cancer Survival Working
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
Faculty 11-Human and Health Science, University of Bremen, 28359 Bremen, Germany.
Cancers (Basel). 2021 Jan 19;13(2):357. doi: 10.3390/cancers13020357.
Many countries have reported survival inequalities due to regional socioeconomic deprivation. To quantify the potential gain from eliminating cancer survival disadvantages associated with area-based deprivation in Germany, we calculated the number of avoidable excess deaths. We used population-based cancer registry data from 11 of 16 German federal states. Patients aged ≥15 years diagnosed with an invasive malignant tumor between 2008 and 2017 were included. Area-based socioeconomic deprivation was assessed using the quintiles of the German Index of Multiple Deprivation (GIMD) 2010 on a municipality level nationwide. Five-year age-standardized relative survival for 25 most common cancer sites and for total cancer were calculated using period analysis. Incidence and number of avoidable excess deaths in Germany in 2013-2016 were estimated. Summed over the 25 cancer sites, 4100 annual excess deaths (3.0% of all excess deaths) could have been avoided each year in Germany during the period 2013-2016 if relative survival were in all regions comparable with the least deprived regions. Colorectal, oral and pharynx, prostate, and bladder cancer contributed the largest numbers of avoidable excess deaths. Our results provide a good basis to estimate the potential of intervention programs for reducing socioeconomic inequalities in cancer burden in Germany.
许多国家都报告了因地区社会经济贫困导致的生存不平等现象。为了量化消除德国基于地区贫困的癌症生存劣势可能带来的潜在收益，我们计算了可避免的额外死亡人数。我们使用了德国16个联邦州中11个州的基于人群的癌症登记数据。纳入了2008年至2017年间诊断为侵袭性恶性肿瘤的≥15岁患者。在全国城市层面，使用2010年德国多重贫困指数（GIMD）的五分位数评估基于地区的社会经济贫困情况。采用时期分析方法计算了25个最常见癌症部位和所有癌症的五年年龄标准化相对生存率。估计了2013 - 2016年德国可避免的额外死亡的发病率和数量。在2013 - 2016年期间，如果所有地区的相对生存率都与最不贫困地区相当，那么在德国，25个癌症部位每年总计4100例额外死亡（占所有额外死亡的3.0%）本可避免。结直肠癌、口腔和咽癌、前列腺癌以及膀胱癌导致的可避免额外死亡人数最多。我们的结果为评估德国减少癌症负担社会经济不平等干预项目的潜力提供了良好依据。
