The proportion of cancers attributable to social deprivation: A population-based analysis of Australian health data. (August 2020)

• Record Type: Journal Article
• Authors: Wilson, Louise F.; Green, Adele C.; Jordan, Susan J.; Neale, Rachel E.; Webb, Penelope M.; Whiteman, David C.
• Is Part Of: Cancer epidemiology. Volume 67(2020:Aug.)
• Publication Date: 2020-08
• Subjects: ABS Australian Bureau of Statistics -- ASR age-standardised incidence rate -- IARC International Agency for Research on Cancer -- IRSD Index of Relative Socioeconomic Disadvantage -- PAF population attributable fraction -- PIF potential impact fraction -- RR relative risk -- Q1 quintile 1 -- Q2 quintile 2 -- Q3 quintile 3 -- Q4 quintile 4 -- Q5 quintile 5 -- WCRF World Cancer Research Fund; Socioeconomic disadvantage -- Cancer -- Population attributable fraction -- Potential impact fraction -- Tobacco smoking -- Obesity -- Physical inactivity -- Alcohol; Cancer -- Epidemiology -- Periodicals; Cancer -- Prevention -- Periodicals; Cancer -- Diagnosis -- Periodicals; Carcinogenesis -- Periodicals; 616.994005
• DOI: 10.1016/j.canep.2020.101742
• Languages: English
• ISSNs: 1877-7821

Abstract

Highlights: Prevalences of smoking, obesity and physical activity are higher in more socioeconomically disadvantaged areas. People in areas of socioeconomic disadvantage also have a disproportionately high incidence of many types of cancer. Disparities could be reduced by lowering exposure to risk factors in disadvantaged areas to levels in advantaged areas. Reducing such disparities could have prevented an estimated 19, 500 cancers in Australia (2009–2013). In disadvantaged areas, reducing smoking overall and obesity in women would have the greatest impact. Abstract: Background: Cancer is a major disease burden globally and people who are socioeconomically disadvantaged have a higher incidence of many types of cancer. We investigated the potential to reduce socioeconomic disparities in cancer incidence in Australia by lowering the prevalence of exposure to four modifiable causes: smoking, alcohol, overweight/obesity and physical inactivity. Methods: We used cancer incidence data from the Australian Cancer Database and risk factor prevalence data from the Australian National Health Survey to estimate the proportions of cancers attributable to the four factors, by area-level socioeconomic disadvantage. For the three risk factors where prevalence was lowest among the least disadvantaged (smoking, overweight/obesity, physical inactivity), we also estimated the potential impact of reducing prevalence in the most disadvantaged areas to that in the least disadvantaged areas. Results: The proportion of cancer attributable to the four factors in combination ranged from 22 % in the most disadvantaged areas to 14 % in the least disadvantaged areas. If the prevalence of tobacco smoking, overweight/obesity and physical inactivity in the more disadvantaged areas were the same as that in the least disadvantaged, an estimated 19, 500 cancers (4 % of all cancers diagnosed) could have been prevented in Australia between 2009 and 2013. Conclusions: Reducing the prevalence of key causal factors in areas of greater social disadvantage would prevent many cases of cancer. Strategies to achieve this in highly disadvantaged areas are needed.