education inequalities implicated in mortality

In a street in Liverpool (England), in May 2020.

Socio-economic inequalities weigh heavily in cancer-related mortality in Europe. And while cancer affects everyone, it hits the least educated the hardest. A team of researchers from the International Agency for Research on Cancer (IARC), an agency of the World Health Organization, in collaboration with the Dutch University Hospital Erasmus MC, as well as a dozen other organizations, analyzed and compared data on the risk of death from cancer according to level of education in eighteen European countries, over a period between 1990 and 2015, and for the entire population aged 40 to 79. This represents approximately 70% of all cancer deaths in Europe.

The findings of the researchers are without appeal. The study published, Monday, November 28, in The Lancet Regional Health Europe and funded by the National Cancer Institute (INCA), confirms to what extent the socio-economic position, here measured by the level of education, plays in the risk of dying from cancer. It offers both a global vision of inequalities by comparing countries but also the populations within each of the States. “Everywhere in Europe, whether you live in the Czech Republic, Finland, Spain or even France, these inequalities exist for most forms of cancer, in particular cancers linked to tobacco and alcohol, that of the lung on your mind “notes Salvatore Vaccarella, epidemiologist at IARC, who coordinated this study.

Social inequalities in cancer mortality have already been pointed out in numerous studies. “This study has the merit of geographical and chronological breadth and offers an interesting photograph”notes the doctor and epidemiologist Jean-David Zeitoun, who did not participate in this work. Geographical differences appear secondary for the most educated categories. On the other hand, when one is poorly educated, the importance of the country comes into play.

High variation from country to country

Mortality rates are higher in the population at the bottom of the social hierarchy and the extent of inequality varies greatly from one country to another, say the IARC researchers. “A substantial fraction – around 32% in men and 16% in women – of cancer deaths are associated with educational inequalities”, they add. Proportion which can reach respectively up to 46% and 24% in Eastern Europe and in the Baltic countries. The study also reveals that less educated men are more than twice as likely to die from lung cancer as those with more education. With regard to cancer of the cervix, women from an underprivileged background have a risk of dying from it three times higher than others.

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