ANTICIPE, Normandy University, Unicaen, INSERM, Centre François Baclesse, Avenue du Général Harris, Caen, France.
Eur J Cancer Prev. 2022 Sep 1;31(5):473-481. doi: 10.1097/CEJ.0000000000000732. Epub 2022 Jan 17.
The existence of socioeconomic inequalities in cancer incidence is now well established and their reduction is a priority in many countries. This study aimed to measure the evolution of socioeconomic inequalities in the incidence of the most common cancers in France, over an 11-year period.
The study focused on 19 cancer entities (16 solid tumors and 3 hematological malignancies). Data are obtained from the French Network of Cancer Registries, representing 604 205 cancer cases. Each patient address was geolocalized and assigned to an IRIS, the smallest geographic unit in France. The French version of the European Deprivation Index was used to measure the level of deprivation in each IRIS. A generalized linear mixed model was used to account for the longitudinal nature of the data and to assess the evolution of socioeconomic inequalities.
A significant evolution of the social gradient of incidence over time was highlighted for five cancer entities and all entities combined. For lung cancer for both sexes and bladder cancer in men, more frequent in deprived areas, the social gradient in incidence tended to decrease over time. For breast cancer in women and lymphocytic leukemia in men, more frequent in affluent areas, the gap continues to widen.
Cancer entities with large disparities continued to present social inequalities in incidence without exacerbation with time. The few temporal evolutions observed do not show a worsening of the social gradient of incidence to the disadvantage of the most deprived areas, but rather an increase in incidence that is greater in the most affluent areas.
癌症发病率存在社会经济不平等现象，这一点现在已经得到充分证实，许多国家都将减少这种不平等视为优先事项。本研究旨在衡量法国在过去 11 年内，最常见癌症发病率的社会经济不平等现象的演变情况。
本研究集中于 19 种癌症实体（16 种实体瘤和 3 种血液恶性肿瘤）。数据来源于法国癌症登记网络，涵盖了 604205 例癌症病例。每位患者的地址都进行了地理定位，并分配到法国最小的地理单位 IRIS。使用法国版欧洲剥夺指数来衡量每个 IRIS 的贫困程度。使用广义线性混合模型来解释数据的纵向性质，并评估社会经济不平等的演变情况。
对于五种癌症实体和所有实体的组合，都强调了时间推移下发病率社会梯度的显著演变。对于男性的肺癌和膀胱癌，以及女性的乳腺癌和男性的淋巴细胞白血病，发病率的社会梯度在时间上呈下降趋势，这些癌症实体在贫困地区更为常见。
具有较大差异的癌症实体继续呈现发病率方面的社会不平等现象，且没有随时间恶化。观察到的少数时间演变并没有显示发病率社会梯度向最贫困地区不利方向的恶化，而是在最富裕地区的发病率增加更多。
