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Trends in prostate cancer incidence and survival in various socioeconomic classes: A population‐based study
Author(s) -
DUTTA ROY SUBHAJIT,
PHILIP JOE,
JAVLE PRADIP
Publication year - 2005
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2005.01111.x
Subject(s) - medicine , socioeconomic status , demography , incidence (geometry) , prostate cancer , proxy (statistics) , population , social deprivation , cancer registry , cancer , gerontology , environmental health , statistics , physics , mathematics , sociology , optics , economics , economic growth
Objectives: Prostate cancer is currently the commonest cancer in men of all ages in UK, but robust demographic data of its distribution in various socioeconomic classes is lacking. We aimed to analyze its incidence, mortality and survival trends in West Midlands, England, from 1986 to 2000 in terms of socioeconomic deprivation. Methods: Data were collated from the regional cancer registry database and a well‐validated demographic score, the Townsend band, was employed as an indicator of social deprivation, including four variables as proxy indicators of socioeconomic status. Individual cases were allocated to one of five deprivation categories using postcode at diagnosis. Regression trend analysis at 1 and 5 years was performed and a P ‐value derived from the t ‐test statistic. Results: In the mid‐1980s, the incidence rate ratio in affluent:deprived classes was 0.9, with age‐standardized rates of 35.23 and 39.53 per 100 000 people. This ratio increased to 1.5 by 2000 with age‐standardized rates of 95.98 and 63.13, respectively (172% increase in affluent compared with 60% in deprived). The affluent groups had a 7 and 13% survival advantage at 1 and 5 years; the survival advantage at 1 year was statistically significant ( P = 0.03). Conclusions: The preferential changes in incidence and survival in the affluent social classes are likely to be due to heightened awareness, resulting in increased prostate‐specific antigen testing, which captures early and relatively slow‐growing tumors with a better overall prognosis. If these bipolar trends are allowed to persist, then the gap between the affluent and deprived will continue to widen.