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Socioeconomic inequalities in lung cancer – a time trend analysis with German health insurance data
BACKGROUND: Lung Cancer (LC) is one of the most prevalent cancer diseases. Due to the lack of databases which allow the combination of information on individual socioeconomic status (SES) and cancer incidence, research on social inequalities in LC among the German population is rare. The aim of the...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7977592/ https://www.ncbi.nlm.nih.gov/pubmed/33740928 http://dx.doi.org/10.1186/s12889-021-10576-4 |
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author | Tetzlaff, Fabian Epping, Jelena Tetzlaff, Juliane Golpon, Heiko Geyer, Siegfried |
author_facet | Tetzlaff, Fabian Epping, Jelena Tetzlaff, Juliane Golpon, Heiko Geyer, Siegfried |
author_sort | Tetzlaff, Fabian |
collection | PubMed |
description | BACKGROUND: Lung Cancer (LC) is one of the most prevalent cancer diseases. Due to the lack of databases which allow the combination of information on individual socioeconomic status (SES) and cancer incidence, research on social inequalities in LC among the German population is rare. The aim of the study is to analyse time trends in social inequalities in LC in Germany. METHODS: The analyses are based on data of a large statutory health insurance provider. The data contain information on diagnoses, occupation and education (working age), and income (full age range) of the insurance population. Trends were analysed for two subpopulations (retirement age and working age) and stratified by sex. The analyses are based on incidence rates and proportional hazard models spanning the periods 2006–2009, 2010–2013 and 2014–2017. RESULTS: Incidence rates declined in men but increased in women. For men, inequalities were strongest in terms of income and the decline in incidence was most pronounced in middle- and higher-income men. Among women at retirement age, a reversed income gradient was found which disappeared in the second period. The educational gradient among the working-age population decreased over time due to the trend towards increasing incidence among individuals with higher education. Declining gradients were also found for occupational position. CONCLUSION: The findings reveal considerable inequalities in LC and that trends vary with respect to SES, sex and age. Widening income inequalities were found in the retired population, while educational and occupational inequalities tend to narrow among the working-age population. |
format | Online Article Text |
id | pubmed-7977592 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-79775922021-03-22 Socioeconomic inequalities in lung cancer – a time trend analysis with German health insurance data Tetzlaff, Fabian Epping, Jelena Tetzlaff, Juliane Golpon, Heiko Geyer, Siegfried BMC Public Health Research Article BACKGROUND: Lung Cancer (LC) is one of the most prevalent cancer diseases. Due to the lack of databases which allow the combination of information on individual socioeconomic status (SES) and cancer incidence, research on social inequalities in LC among the German population is rare. The aim of the study is to analyse time trends in social inequalities in LC in Germany. METHODS: The analyses are based on data of a large statutory health insurance provider. The data contain information on diagnoses, occupation and education (working age), and income (full age range) of the insurance population. Trends were analysed for two subpopulations (retirement age and working age) and stratified by sex. The analyses are based on incidence rates and proportional hazard models spanning the periods 2006–2009, 2010–2013 and 2014–2017. RESULTS: Incidence rates declined in men but increased in women. For men, inequalities were strongest in terms of income and the decline in incidence was most pronounced in middle- and higher-income men. Among women at retirement age, a reversed income gradient was found which disappeared in the second period. The educational gradient among the working-age population decreased over time due to the trend towards increasing incidence among individuals with higher education. Declining gradients were also found for occupational position. CONCLUSION: The findings reveal considerable inequalities in LC and that trends vary with respect to SES, sex and age. Widening income inequalities were found in the retired population, while educational and occupational inequalities tend to narrow among the working-age population. BioMed Central 2021-03-19 /pmc/articles/PMC7977592/ /pubmed/33740928 http://dx.doi.org/10.1186/s12889-021-10576-4 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Tetzlaff, Fabian Epping, Jelena Tetzlaff, Juliane Golpon, Heiko Geyer, Siegfried Socioeconomic inequalities in lung cancer – a time trend analysis with German health insurance data |
title | Socioeconomic inequalities in lung cancer – a time trend analysis with German health insurance data |
title_full | Socioeconomic inequalities in lung cancer – a time trend analysis with German health insurance data |
title_fullStr | Socioeconomic inequalities in lung cancer – a time trend analysis with German health insurance data |
title_full_unstemmed | Socioeconomic inequalities in lung cancer – a time trend analysis with German health insurance data |
title_short | Socioeconomic inequalities in lung cancer – a time trend analysis with German health insurance data |
title_sort | socioeconomic inequalities in lung cancer – a time trend analysis with german health insurance data |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7977592/ https://www.ncbi.nlm.nih.gov/pubmed/33740928 http://dx.doi.org/10.1186/s12889-021-10576-4 |
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