Cancer: Social injustice influences the rates in Germany

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Social inequality in Germany has a significant impact on the rate of new cancer cases – and this trend is increasing. This is what a German research team reports after analyzing data from eight federal states. Accordingly, the age-standardized rate of new cancers has been declining for years. However, this trend is much clearer in socially better off regions than elsewhere, writes the team led by Lina Jansen from the German Cancer Research Center (DKFZ) in the “International Journal of Cancer”.

Higher cancer incidence among men in poorer regions

Studies from Germany and other countries show that social inequality can influence the rate of cancer. In Germany, between 2010 and 2013, 7.3 percent more men in the socio-economically weakest regions contracted cancer than in the wealthiest areas.

However, since 2007, the age-standardized incidence rate for almost all types of cancer has been falling in Germany – with the exception of lung cancer in women. According to the researchers, however, little research has been carried out into how social inequalities affect this trend.

Analysis of cancer diagnoses in eight federal states

The team has now examined the development of cancer diagnoses for eight German federal states with a total of around 49 million inhabitants – 60 percent of the total German population – for the period from 2007 to 2018. Hesse, Baden-Württemberg, Berlin and the five eastern German states were not taken into account due to poor data availability Federal states.

The study compared the cancer diagnoses at county and district level with the respective socio-economic index. It was divided into five groups, including by

Income, Employment Rate, Education, Environment, and Security.

Weak declines for colorectal cancer and lung cancer in disadvantaged regions

For all groups, the incidence rate fell from 2007 to 2018 for almost all types of cancer. However, for all cancers, as well as for colorectal cancer and lung cancer, the declines in men in the most disadvantaged regions were significantly weaker than those in the more affluent areas.

And this inequality increased over the observation period: In 2007, men in the socio-economically weakest regions had an

7 percent higher cancer incidence rate

than in the least favored areas, this difference increased

on 23 percent in 2018.

For women, it rose a little less:

from also 7 on 20 percent.

This discrepancy was particularly pronounced in lung cancer: In 2018, it occurred in the socio-economically weakest regions compared to the most affluent areas for men

and even in women

more frequently.

Social factors more important than infrastructure in the development of cancer

Further analyzes provide indications of the causes of this trend: The healthcare system – such as the density of doctors, distance to the nearest medical center, number of hospital beds or nursing homes – did not differ very much between the socio-economically different regions. “So the social factors seem to play a much bigger role than the general infrastructure,” concludes Jansen.

On the other hand, there is a clear socio-economic gap in the prevalence of tobacco and alcohol consumption, lack of exercise or severe obesity – all factors that can increase the risk of cancer. “Our results show once again that we must make special efforts in the future to ensure that all people benefit equally from recommendations for a healthy lifestyle and from cancer screening tests – regardless of their postcode,” emphasizes Jansen.

Nine things you can do to reduce your risk of cancer

Preventive measures can significantly reduce the risk of cancer. Cancer and prevention researchers have known for some time how important these are. The nine most important points to reduce the risk of disease are:

Avoid being overweight Move every day Eat healthy Don’t smoke Drink as little alcohol as possible Avoid carcinogenic substances Protect from UV radiation Vaccination against cancer (hepatitis B; HPV) Use offers for early cancer detection