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The impact of adjustment for socioeconomic status on comparisons of cancer incidence between two European countries

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journal contribution
posted on 2014-05-16, 13:11 authored by David W. Donnelly, Avril C. Hegarty, Linda Sharp, Anne-Elie Carsin, Sandra Deady, Neil McCluskey, Harry Comber, Anna Gavin
Background. Cancer incidence rates vary considerably between countries and by socioeconomic status (SES). We investigate the impact of SES upon the relative cancer risk in two neighbouring countries. Methods. Data on 229,824 cases for 16 cancers diagnosed in 1995–2007 were extracted from the cancer registries in Northern Ireland (NI) and Republic of Ireland (RoI). Cancers in the two countries were compared using incidence rate ratios (IRRs) adjusted for age and age plus area-based SES. Results. Adjusting for SES in addition to age had a considerable impact on NI/RoI comparisons for cancers strongly related to SES. Before SES adjustment, lung cancer incidence rates were 11% higher for males and 7% higher for females in NI, while after adjustment, the IRR was not statistically significant. Cervical cancer rates were lower in NI than in RoI after adjustment for age (IRR: 0.90 (0.84–0.97)), with this difference increasing after adjustment for SES (IRR: 0.85 (0.79–0.92)). For cancers with a weak or nonexistent relationship to SES, adjustment for SES made little difference to the IRR. Conclusion. Socioeconomic factors explain some international variations but also obscure other crucial differences; thus, adjustment for these factors should not become part of international comparisons

Funding

Development of a structure identification methodology for nonlinear dynamic systems

National Research Foundation

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History

Publication

Journal of Cancer Epidemiology;Article ID 612514

Publisher

Hindawi Publishing Corporation

Note

peer-reviewed

Other Funding information

Public Health (Agency) Northern Ireland, HRB

Language

English

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