Skip to main content

Advertisement

SpringerLink
Log in

Inequalities in cancer incidence and mortality across medium to highly developed countries in the twenty-first century

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Purpose

Inequalities in the burden of cancer have been well documented, and a variety of measures exist to analyse disease disparities. While previous studies have focused on inequalities within countries, the aim of the present study was to quantify existing inequalities in cancer incidence and mortality between countries.

Methods

Data on total and site-specific cancer incidence and mortality in 2003–2007 were obtained for 43 countries with medium-to-high levels of human development via Cancer Incidence in Five Continents Vol. X and the WHO Mortality Database. We calculated the concentration index as a summary measure of socioeconomic-related inequality between countries.

Results

Inequalities in cancer burden differed markedly by site; the concentration index for all sites combined was 0.03 for incidence and 0.02 for mortality, pointing towards a slightly higher burden in countries with higher levels of the human development index (HDI). For both incidence and mortality, this pattern was most pronounced for melanoma. In contrast, the burden of cervical cancer was disproportionally high in countries with lower HDI levels. Prostate, lung and breast cancer contributed most to inequalities in overall cancer incidence in countries with higher HDI levels, while for mortality these were mostly driven by lung cancer in higher HDI countries and stomach cancer in countries with lower HDI levels.

Conclusion

Global inequalities in the burden of cancer remain evident at the beginning of the twenty-first century: with a disproportionate burden of lifestyle-related cancers in countries classified as high HDI, while infection-related cancers continue to predominate in transitioning countries with lower levels of HDI.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ferlay J, Soerjomataram I, Ervik M et al (2013) GLOBOCAN 2012 v1.0, cancer incidence and mortality worldwide: IARC cancer base no. 11. International agency for research on cancer, Lyon

    Google Scholar 

  2. Mackenbach JP, Bakker M (2002) Reducing inequalities in health: a European perspective. Routledge, New York

    Google Scholar 

  3. Jones LA, Chilton JA, Hajek RA, Iammarino NK, Laufman L (2006) Between and within: international perspectives on cancer and health disparities. J Clin Oncol 24:2204–2208

    Article  PubMed  Google Scholar 

  4. Mackenbach JP, Stirbu I, Roskam AJ et al (2008) Socioeconomic inequalities in health in 22 European countries. N Engl J Med 358:2468–2481

    Article  CAS  PubMed  Google Scholar 

  5. Aarts MJ, van der Aa MA, Coebergh JW, Louwman WJ (2010) Reduction of socioeconomic inequality in cancer incidence in the South of the Netherlands during 1996–2008. Eur J Cancer 46:2633–2646

    Article  CAS  PubMed  Google Scholar 

  6. Bray F, Jemal A, Grey N, Ferlay J, Forman D (2012) Global cancer transitions according to the human development index (2008–2030): a population-based study. Lancet Oncol 13:790–801

    Article  PubMed  Google Scholar 

  7. United Nations Development Programme (UNDP) (2007) Human development report 2007/2008. Fighting climate change: human solidarity in a divided world. In: UNDP (ed) United Nations Development Programme (UNDP), New York. http://hdr.undp.org/sites/default/files/reports/268/hdr_20072008_en_complete.pdf

  8. Forman D, Bray F, Brewster DH et al (2013) Cancer incidence in five continents, vol 10. IARC, Lyon (electronic version)

    Google Scholar 

  9. World Health Organization. WHO Mortality Database. www.who.int/healthinfo/mortality_data/en/

  10. Mathers CD, Fat DM, Inoue M, Rao C, Lopez AD (2005) Counting the dead and what they died from: an assessment of the global status of cause of death data. Bull World Health Organ 83:171–177

    PubMed  PubMed Central  Google Scholar 

  11. Conway DI, Brenner DR, McMahon AD et al (2015) Estimating and explaining the effect of education and income on head and neck cancer risk: INHANCE consortium pooled analysis of 31 case-control studies from 27 countries. Int J Cancer 136(1125–39):17

    Google Scholar 

  12. Boscoe FP, Johnson CJ, Sherman RL, Stinchcomb DG, Lin G, Henry KA (2014) The relationship between area poverty rate and site-specific cancer incidence in the United States. Cancer 120:2191–2198

    Article  PubMed  Google Scholar 

  13. United Nations, Department of Economic and Social Affairs, Population Division (2011) World population prospects: the 2010 revision. New York

  14. O’Donnell O, Van Doorslaer E, Wagstaff A, Lindelow M (2008) Analyzing health equity using household survey data. A guide to techniques and their implementation. The World Bank, Washington

    Google Scholar 

  15. Wagstaff A (2000) Socioeconomic inequalities in child mortality: comparisons across nine developing countries. Bull World Health Organ 78:19–29

    CAS  PubMed  PubMed Central  Google Scholar 

  16. van Doorslaer E, Wagstaff A, Bleichrodt H et al (1997) Income-related inequalities in health: some international comparisons. J Health Econ 16:93–112

    Article  PubMed  Google Scholar 

  17. van Doorslaer E, Masseria C, Koolman X, OECD Health Equity Research Group (2006) Inequalities in access to medical care by income in developed countries. CMAJ 174:177–183

    Article  PubMed  PubMed Central  Google Scholar 

  18. McGrail KM, van Doorslaer E, Ross NA, Sanmartin C (2009) Income-related health inequalities in Canada and the United States: a decomposition analysis. Am J Public Health 99:1856–1863

    Article  PubMed  PubMed Central  Google Scholar 

  19. Wagstaff A, Paci P, van Doorslaer E (1991) On the measurement of inequalities in health. Soc Sci Med 33:545–557

    Article  CAS  PubMed  Google Scholar 

  20. O’Donnell O, O’Neill S, Van Ourti T, Walsh B (2016) Conindex: estimation of concentration indices. Stata J 16:112–138

    PubMed  PubMed Central  Google Scholar 

  21. Koolman X, van Doorslaer E (2004) On the interpretation of a concentration index of inequality. Health Econ 13:649–656

    Article  PubMed  Google Scholar 

  22. Wagstaff A, van Doorslaer E, Watanabe N (2003) On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam. J Econom 112:207–223

    Article  Google Scholar 

  23. Clarke PM, Gerdtham UG, Connelly LB (2003) A note on the decomposition of the health concentration index. Health Econ 12(511–6):18

    Google Scholar 

  24. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM (2010) Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 127:2893–2917

    Article  CAS  PubMed  Google Scholar 

  25. Thun M, Peto R, Boreham J, Lopez AD (2012) Stages of the cigarette epidemic on entering its second century. Tob Control 21:96–101

    Article  PubMed  Google Scholar 

  26. Ng M, Freeman MK, Fleming TD et al (2014) Smoking prevalence and cigarette consumption in 187 countries, 1980–2012. JAMA 311:183–192

    Article  CAS  PubMed  Google Scholar 

  27. Erdmann F, Lortet-Tieulent J, Schuz J et al (2013) International trends in the incidence of malignant melanoma 1953–2008—are recent generations at higher or lower risk? Int J Cancer 132:385–400

    Article  CAS  PubMed  Google Scholar 

  28. Znaor A, Lortet-Tieulent J, Jemal A, Bray F (2014) International variations and trends in testicular cancer incidence and mortality. Eur Urol 65:1095–1106

    Article  PubMed  Google Scholar 

  29. Uthman OA, Jadidi E, Moradi T (2013) Socioeconomic position and incidence of gastric cancer: a systematic review and meta-analysis. J Epidemiol Community Health 67:854–860

    Article  PubMed  Google Scholar 

  30. Franceschi S, Plummer M, Clifford G et al (2009) Differences in the risk of cervical cancer and human papillomavirus infection by education level. Br J Cancer 101:865–870

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. de Martel C, Ferlay J, Franceschi S et al (2012) Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol 13:607–615

    Article  PubMed  Google Scholar 

  32. Walboomers JM, Jacobs MV, Manos MM et al (1999) Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 189:12–19

    Article  CAS  PubMed  Google Scholar 

  33. Plummer M, Franceschi S, Vignat J, Forman D, de Martel C (2015) Global burden of gastric cancer attributable to Helicobacter pylori. Int J Cancer 136:487–490

    Article  CAS  PubMed  Google Scholar 

  34. Soerjomataram I, Lortet-Tieulent J, Parkin DM et al (2012) Global burden of cancer in 2008: a systematic analysis of disability-adjusted life-years in 12 world regions. Lancet 380:1840–1850

    Article  PubMed  Google Scholar 

  35. Allemani C, Storm H, Voogd AC et al (2010) Variation in ‘standard care’ for breast cancer across Europe: a EUROCARE-3 high resolution study. Eur J Cancer 46(1528–36):19

    Google Scholar 

  36. Micheli A, Coebergh JW, Mugno E et al (2003) European health systems and cancer care. Ann Oncol 14(Suppl 5):v41–v60

    Article  PubMed  Google Scholar 

  37. Aarts MJ, Kamphuis CB, Louwman MJ, Coebergh JW, Mackenbach JP, van Lenthe FJ (2013) Educational inequalities in cancer survival: a role for comorbidities and health behaviours? J Epidemiol Community Health 67:365–373

    Article  PubMed  Google Scholar 

  38. Harper S, Lynch J, Meersman SC, Breen N, Davis WW, Reichman ME (2008) An overview of methods for monitoring social disparities in cancer with an example using trends in lung cancer incidence by area-socioeconomic position and race-ethnicity, 1992–2004. Am J Epidemiol 167:889–899

    Article  PubMed  PubMed Central  Google Scholar 

  39. Harper S, Lynch J, Meersman SC, Breen N, Davis WW, Reichman MC (2009) Trends in area-socioeconomic and race-ethnic disparities in breast cancer incidence, stage at diagnosis, screening, mortality, and survival among women ages 50 years and over (1987–2005). Cancer Epidemiol Biomark Prev 18:121–131

    Article  Google Scholar 

Download references

Author contribution

This study was conceived and designed by MA, TVO and IS. MA conducted the statistical analyses and wrote the first draft of the manuscript. All authors contributed to critical revisions of the manuscript and approved the final submitted version.

Author information

Authors and Affiliations

  1. Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008, Lyon, France

    Melina Arnold, Elisenda Rentería, Freddie Bray & Isabelle Soerjomataram

  2. School of Medicine, Dentistry, and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, 378 Sauchiehall Street, Glasgow, G2 3JZ, UK

    David I. Conway

  3. Erasmus School of Economics and Tinbergen Institute, University of Rotterdam, Burgemeester Oudlaan 50, PO Box 1738, 3000 DR, Rotterdam, The Netherlands

    Tom Van Ourti

Authors
  1. Melina Arnold
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elisenda Rentería
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David I. Conway
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Freddie Bray
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tom Van Ourti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Isabelle Soerjomataram
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Melina Arnold.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 40 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Arnold, M., Rentería, E., Conway, D.I. et al. Inequalities in cancer incidence and mortality across medium to highly developed countries in the twenty-first century. Cancer Causes Control 27, 999–1007 (2016). https://doi.org/10.1007/s10552-016-0777-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-016-0777-7

Keywords

Search

Navigation