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Trends in inequalities in premature cancer mortality by educational level in Colombia, 1998-2007

de Vries, Esther, Arroyave, Ivan, Pardo, Constanza, Wiesner, Carolina, Murillo, Raul, Forman, David, Burdorf, Alex and Avendano, Mauricio (2015) Trends in inequalities in premature cancer mortality by educational level in Colombia, 1998-2007. Journal of Epidemiology and Community Health, 69. pp. 408-415. ISSN 0143-005X

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Identification Number: 10.1136/jech-2014-204650


Background There is a paucity of studies on socioeconomic inequalities in cancer mortality in developing countries. We examined trends in inequalities in cancer mortality by educational attainment in Colombia during a period of epidemiological transition and rapid expansion of health insurance coverage. Methods Population mortality data (1998–2007) were linked to census data to obtain age-standardised cancer mortality rates by educational attainment at ages 25–64 years for stomach, cervical, prostate, lung, colorectal, breast and other cancers. We used Poisson regression to model mortality by educational attainment and estimated the contribution of specific cancers to the slope index of inequality in cancer mortality. Results We observed large educational inequalities in cancer mortality, particularly for cancer of the cervix (rate ratio (RR) primary vs tertiary groups=5.75, contributing 51% of cancer inequalities), stomach (RR=2.56 for males, contributing 49% of total cancer inequalities and RR=1.98 for females, contributing 14% to total cancer inequalities) and lung (RR=1.64 for males contributing 17% of total cancer inequalities and 1.32 for females contributing 5% to total cancer inequalities). Total cancer mortality rates declined faster among those with higher education, with the exception of mortality from cervical cancer, which declined more rapidly in the lower educational groups. Conclusions There are large socioeconomic inequalities in preventable cancer mortality in Colombia, which underscore the need for intensifying prevention efforts. Reduction of cervical cancer can be achieved through reducing human papilloma virus infection, early detection and improved access to treatment of preneoplastic lesions. Reinforcing antitobacco measures may be particularly important to curb inequalities in cancer mortality.

Item Type: Article
Official URL:
Additional Information: © 2014 BMJ Publishing Group Ltd
Divisions: Social Policy
LSE Health
Lifecourse, Ageing & Population Health
Subjects: H Social Sciences > HN Social history and conditions. Social problems. Social reform
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited: 09 Mar 2015 09:54
Last Modified: 16 May 2024 02:01
Projects: ERC grant No 263684, R01AG040248 and R01AG037398
Funders: Rotterdam Global Health Initiative, International Agency for Research on Cancer, Union for International Cancer Control, Union Erasmus Mundus Partnerships Programme Erasmus-Columbus 2013 (Eracol), European Research Council, National Institute on Aging, McArthur Foundation Research Network on Ageing

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