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Socioeconomic inequalities in colorectal cancer incidence in Canada: trends over two decades

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Abstract

Purpose

Colorectal cancer is the third most commonly diagnosed cancer in Canada. This study aimed to measure and examine trends in socioeconomic inequalities in the incidence of colorectal cancer in Canada.

Methods

This study is a time trend ecological study based on Canadian Census Division level data constructed from the Canadian Cancer Registry, Canadian Census of Population, and National Household Survey. We assessed trends in income and education inequalities in colorectal cancer incidence in Canada from 1992 to 2010. The age-standardized Concentration index (\(C\)), which measures inequality across all socioeconomic groups, was used to quantify socioeconomic inequalities in colorectal cancer incidence in Canada.

Results

The average crude colorectal cancer incidence was found to be 61.52 per 100,000 population over the study period, with males having a higher incidence rate than females (males: 66.98; females: 56.25 per 100,000 population). The crude incidence increased over time and varied by province. The age-standardized C indicated a higher concentration of colorectal cancer incidence among lower income and less-educated neighborhoods in Canada. Income and education inequalities increased over time among males.

Conclusion

The concentration of colorectal cancer incidence in low socioeconomic neighborhoods in Canada has implications for primary prevention and screening.

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Acknowledgments

The analyses for this paper were conducted at the Statistics Canada’s Atlantic Research Data Centre (ARDC) at Dalhousie University, which is part of the Canadian Research Data Centre Network (CRDCN). We would like to thank the CRDCN for facilitating access to the Canadian Cancer Registry, Canadian Census of Population, and the National Household Survey. We also would like to thank Min Hu for his research assistance and the two anonymous reviewers of the journal for their thoughtful comments on the manuscript.

Funding

We acknowledge funding for this research provided by the Faculty of Health—Research Development Grant, Dalhousie University.

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Authors and Affiliations

  1. School of Health Administration, Faculty of Health, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd Floor, Halifax, NS, B3H 4R2, Canada

    Mohammad Hajizadeh

  2. Faculty of Medicine, Dalhousie University, Halifax, Canada

    Marie Charles

  3. Cancer Care Program, Nova Scotia Health, School of Health Administration, Dalhousie University, Halifax, Canada

    Grace M. Johnston

  4. Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Canada

    Robin Urquhart

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  1. Mohammad Hajizadeh
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  2. Marie Charles
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Corresponding author

Correspondence to Mohammad Hajizadeh.

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We declare that we have no conflict of interest.

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We accessed the Canadian Cancer Registry, Canadian Census of Population, and National Household Survey through Statistics Canada’s Research Data Centre (RDC). Data accessed through the RDC, which follows strict disclosure protocols in accordance with the Statistics Acts, is exempt from approval by the Research Ethics Board (REB) as per Tri-Council Policy Statement: Ethical conduct for research involving humans (TCPS2) article 2.2 (a).

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Hajizadeh, M., Charles, M., Johnston, G.M. et al. Socioeconomic inequalities in colorectal cancer incidence in Canada: trends over two decades. Cancer Causes Control 33, 193–204 (2022). https://doi.org/10.1007/s10552-021-01518-x

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