School of Health Administration, Faculty of Health, 3688Dalhousie University, Halifax, NS, Canada.
12361Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
Cancer Control. 2021 Jan-Dec;28:10732748211055272. doi: 10.1177/10732748211055272.
Understanding the effects of socioeconomic status on cancer incidence and their trends over time will help inform public health interventions for cancer control. This study sought to investigate trends in socioeconomic inequalities in prostate cancer incidence among Canadian males.
Using a census division level dataset (n = 280) constructed from the Canadian Cancer Registry, Canadian Census of Population (1992, 1996, 2001, 2006) and 2011 National Household Survey, we examined the effect of socioeconomic status on prostate cancer incidence among Canadian males between 1992 and 2010. The age-adjusted concentration index was used to quantify education/income-related inequalities in prostate cancer incidence.
The crude prostate cancer incidence increased from 115 to 137 per 100 000 males in Canada from 1992 to 2010 with a peak in 2007. The rate increased significantly in all but three of four western provinces. The age-adjusted concentration index showed a higher concentration of prostate cancer diagnoses among males living in high-income neighbourhoods in Canada in particular from 1996 to 2005. In contrast, the index was higher among males living in less-educated neighbourhoods in the most recent study years (2006-2010).
The concentration of new prostate cancer cases among high-income populations in Canada may be explained by the rise of opportunistic screening of asymptomatic males; however, this should be studied in further detail. Since we found a higher incidence rate of prostate cancer among less-educated males in Canada in recent years, risk-benefit investigation of primary prevention and opportunistic screening for less-educated males is advised.
了解社会经济地位对癌症发病率的影响及其随时间的变化趋势，将有助于为癌症控制提供公共卫生干预措施。本研究旨在调查加拿大男性前列腺癌发病率的社会经济不平等趋势随时间的变化。
使用从加拿大癌症登记处、加拿大人口普查（1992 年、1996 年、2001 年、2006 年）和 2011 年全国住户调查构建的按普查分区水平的数据组（n=280），我们检验了社会经济地位对 1992 年至 2010 年间加拿大男性前列腺癌发病率的影响。使用年龄调整集中指数来量化与教育/收入相关的前列腺癌发病率不平等。
1992 年至 2010 年期间，加拿大男性的粗前列腺癌发病率从 115 例/100000 男性增加到 137 例/100000 男性，2007 年达到峰值。除三个西部省份外，所有其他省份的发病率都显著增加。年龄调整后的集中指数显示，加拿大高收入社区的男性前列腺癌诊断更为集中，尤其是在 1996 年至 2005 年期间。相比之下，在最近的研究年份（2006 年至 2010 年）中，指数在受教育程度较低的男性居住的社区中更高。
加拿大高收入人群中新增前列腺癌病例的集中可能是由于对无症状男性进行机会性筛查的增加所致；然而，这需要进一步详细研究。由于我们发现近年来加拿大受教育程度较低的男性前列腺癌发病率较高，建议对受教育程度较低的男性进行初级预防和机会性筛查的风险-效益调查。
