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Lung, Breast and Colorectal Cancer Incidence by Socioeconomic Status in Spain: A Population-Based Multilevel Study

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Non-Communicable Disease and Cancer Epidemiology Group, Instituto de Investigación Biosanitaria de Granada, ibs.GRANADA, Calle Doctor Azpitarte 4, 18012 Granada, Spain
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Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), 28029 Madrid, Spain
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Andalusian School of Public Health, Cuesta del Observatorio 4, 18080 Granada, Spain
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Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Av. França, s/n, 17004 Girona, Spain
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Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), 17190 Girona, Spain
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Tarragona Cancer Registry, Cancer Epidemiology and Prevention Service, Hospital Universitari Sant Joan de Reus, Av. Josep Laporte, 2, 43204 Reus, Spain
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Pere Virgili Health Research Institute (IISPV), Av. Josep Laporte, 2, 43204 Reus, Spain
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Basque Country Cancer Registry, Health Department, Basque Government, Calle Donostia, 1, 01010 Vitoria-Gasteiz, Spain
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Castellón Cancer Registry, Comunitat Valenciana Cancer Information System, Department of Health, Autonomous Government of Comunitat Valenciana, Av. De Cataluña, 21, 46020 València, Spain
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Cuenca Cancer Registry, Department of Public Health, Autonomous Government of Castilla la Mancha, Calle de las Torres, 43, 16071 Cuenca, Spain
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Navarra Public Health Institute, Calle Leyre, 15, 31003 Pamplona, Spain
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IdiSNA, Navarra Institute for Health Research, Calle Irunlarrea, 3, 31008 Pamplona, Spain
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Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, National Institute of Health Carlos III, Av. Monforte de Lemos, 5, 28029 Madrid, Spain
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Department of Preventive Medicine and Public Health, University of Granada, Av. De la Investigación, 11, 18071 Granada, Spain
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Department of Noncommunicable Disease Epidemiology, ICON Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
*
Author to whom correspondence should be addressed.
Authors acted with equal contribution as senior authors.
Academic Editor: Anne-Marie Bouvier
Cancers 2021, 13(11), 2820; https://doi.org/10.3390/cancers13112820
Received: 14 April 2021 / Revised: 27 May 2021 / Accepted: 31 May 2021 / Published: 5 June 2021
(This article belongs to the Section Cancer Epidemiology and Prevention)
Despite political efforts across the world and Europe, social inequalities in cancer incidence are persistent. We studied the association between socioeconomic status (SES) and cancer incidence in nine Spanish provinces. Lower SES was associated with an increased risk of lung cancer among males. Higher SES was associated with an increased risk of breast cancer among females in Spain. Understanding the reasons behind the association between cancer incidence and SES could help develop appropriate public health programs to promote health and reduce socioeconomic inequalities in cancer incidence in Spain.
Socioeconomic inequalities in cancer incidence are not well documented in southern Europe. We aim to study the association between socioeconomic status (SES) and colorectal, lung, and breast cancer incidence in Spain. We conducted a multilevel study using data from Spanish population-based cancer registries, including incident cases diagnosed for the period 2010–2013 in nine Spanish provinces. We used Poisson mixed-effects models, including the census tract as a random intercept, to derive cancer incidence rate ratios by SES, adjusted for age and calendar year. Male adults with the lowest SES, compared to those with the highest SES, showed weak evidence of being at increased risk of lung cancer (risk ratio (RR): 1.18, 95% CI: 0.94–1.46) but showed moderate evidence of being at reduced risk of colorectal cancer (RR: 0.84, 95% CI: 0.74–0.97). Female adults with the lowest SES, compared to those with the highest SES, showed strong evidence of lower breast cancer incidence with 24% decreased risk (RR: 0.76, 95% CI: 0.68–0.85). Among females, we did not find evidence of an association between SES and lung or colorectal cancer. The associations found between SES and cancer incidence in Spain are consistent with those obtained in other European countries. View Full-Text
Keywords: socioeconomic inequalities; colorectal cancer; lung cancer; breast cancer; epidemiology; population-based study socioeconomic inequalities; colorectal cancer; lung cancer; breast cancer; epidemiology; population-based study
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MDPI and ACS Style

Redondo-Sánchez, D.; Marcos-Gragera, R.; Carulla, M.; Lopez de Munain, A.; Sabater Gregori, C.; Jimenez Chillarón, R.; Guevara, M.; Nuñez, O.; Fernández-Navarro, P.; Sánchez, M.-J.; Luque-Fernandez, M.A. Lung, Breast and Colorectal Cancer Incidence by Socioeconomic Status in Spain: A Population-Based Multilevel Study. Cancers 2021, 13, 2820. https://doi.org/10.3390/cancers13112820

AMA Style

Redondo-Sánchez D, Marcos-Gragera R, Carulla M, Lopez de Munain A, Sabater Gregori C, Jimenez Chillarón R, Guevara M, Nuñez O, Fernández-Navarro P, Sánchez M-J, Luque-Fernandez MA. Lung, Breast and Colorectal Cancer Incidence by Socioeconomic Status in Spain: A Population-Based Multilevel Study. Cancers. 2021; 13(11):2820. https://doi.org/10.3390/cancers13112820

Chicago/Turabian Style

Redondo-Sánchez, Daniel, Rafael Marcos-Gragera, Marià Carulla, Arantza Lopez de Munain, Consol Sabater Gregori, Rosario Jimenez Chillarón, Marcela Guevara, Olivier Nuñez, Pablo Fernández-Navarro, María-José Sánchez, and Miguel A. Luque-Fernandez 2021. "Lung, Breast and Colorectal Cancer Incidence by Socioeconomic Status in Spain: A Population-Based Multilevel Study" Cancers 13, no. 11: 2820. https://doi.org/10.3390/cancers13112820

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