Jansen, Lina and Schwettmann, Lars and Behr, Christian and Eberle, Andrea and Holleczek, Bernd and Justenhoven, Christina and Kajüter, Hiltraud and Manz, Kirsi and Peters, Frederik and Pritzkuleit, Ron and Schmidt‐Pokrzywniak, Andrea and Sirri, Eunice and Tetzlaff, Fabian and Voigtländer, Sven and Arndt, Volker (2023) Trends in cancer incidence by socioeconomic deprivation in Germany in 2007 to 2018: an ecological registry‐based study. International journal of cancer, 153 (10). pp. 1784-1796. ISSN 0020-7136

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Official URL: https://doi.org/10.1002/ijc.34662


Age-standardized cancer incidence has decreased over the last years for many cancer sites in developed countries. Whether these trends led to narrowing or widening socioeconomic inequalities in cancer incidence is unknown. Using cancer registry data covering 48 million inhabitants in Germany, the ecological association between age-standardized total and site specific (colorectal, lung, prostate and breast) cancer incidence in 2007 to 2018 and a deprivation index on district level (aggregated to quintiles) was investigated. Incidence in the most and least deprived districts were compared using Poisson models. Average annual percentage changes (AAPCs) and differences in AAPCs between deprivation quintiles were assessed using Joinpoint regression analyses. Age-standardized incidence decreased strongly between 2007 and 2018 for total cancer and all cancer sites (except female lung cancer), irrespective of the level of deprivation. However, differences in the magnitude of trends across deprivation quintiles resulted in increasing inequalities over time for total cancer, colorectal and lung cancer. For total cancer, the incidence rate ratio between the most and least deprived quintile increased from 1.07 (95% confidence interval: 1.01-1.12) to 1.23 (1.12-1.32) in men and from 1.07 (1.01-1.13) to 1.20 (1.14-1.26) in women. Largest inequalities were observed for lung cancer with 82% (men) and 88% (women) higher incidence in the most vs the least deprived regions in 2018. The observed increase in inequalities in cancer incidence is in alignment with trends in inequalities in risk factor prevalence and partly utilization of screening. Intervention programs targeted at socioeconomically deprived and urban regions are highly needed.

Item Type: Article
Uncontrolled Keywords: cancer, deprivation, Germany, incidence, trends
Subjects: Technology, medicine, applied sciences > Medicine and health
Divisions: Faculty of Medicine and Health Sciences > Department of Public Health and Medical Education
Date Deposited: 20 Sep 2023 09:05
Last Modified: 28 Sep 2023 09:56
URI: https://oops.uni-oldenburg.de/id/eprint/5853
URN: urn:nbn:de:gbv:715-oops-59349
DOI: 10.1002/ijc.34662

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