ArticleInternational journal for equity in health2023
Socio-economic inequalities in lung cancer mortality in Spain: a nation-wide study using area-based deprivation.
Article in International journal for equity in health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed.
- Spatial Variations and Gender Differences in the Associations Between Lung Cancer Mortality Rate and Contextual Factors: A County-Level Cross-Sectional Ecological Analysis.Journal of prevention (2022) · 2026Article
- Impact of social determinants on the development, diagnosis, and treatment of cancer: recommended public health interventions.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- Trends in socioeconomic inequalities in preventable lung cancer mortality in three major Spanish cities of the Valencian Community, 2000-2015.Scientific reports · 2026Article
- Article
- Comparative Evaluation of Explainable Machine Learning Versus Linear Regression for Predicting County-Level Lung Cancer Mortality Rate in the United States.JCO clinical cancer informatics · 2025Article
- Article
- Risk Factors and Preventive Measures for Lung Cancer in the European Union.Epidemiologia (Basel, Switzerland) · 2024Article
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Abstract
backgroundLung cancer is the main cause of cancer mortality worldwide and in Spain. Several previous studies have documented socio-economic inequalities in lung cancer mortality but these have focused on specific provinces or cities. The goal of this study was to describe lung cancer mortality in Spain by sex as a function of socio-economic deprivation.
methodsWe analysed all registered deaths from lung cancer during the period 2011-2017 in Spain. Mortality data was obtained from the National Institute of Statistics, and socio-economic level was measured with the small-area deprivation index developed by the Spanish Society of Epidemiology, with the census tract of residence at the time of death as the unit of analysis. We computed crude and age-standardized rates per 100,000 inhabitants by sex, deprivation quintile, and type of municipality (rural, semi-rural, urban) considering the 2013 European standard population (ASR-E). We further calculated ASR-E ratios between the most deprived (Q5) and the least deprived (Q1) areas and mapped census tract smoothed standardized lung cancer mortality ratios by sex.
resultsWe observed 148,425 lung cancer deaths (80.7% in men), with 73.5 deaths per 100,000 men and 17.1 deaths per 100,000 women. Deaths from lung cancer in men were five times more frequent than in women (ASR-E ratio = 5.3). Women residing in the least deprived areas had higher mortality from lung cancer (ASR-E = 22.2), compared to women residing in the most deprived areas (ASR-E = 13.2), with a clear gradient among the quintiles of deprivation. For men, this pattern was reversed, with the highest mortality occurring in areas of lower socio-economic level (ASR-E = 99.0 in Q5 vs. ASR-E = 86.6 in Q1). These socio-economic inequalities remained fairly stable over time and across urban and rural areas.
conclusionsSocio-economic status is strongly related to lung cancer mortality, showing opposite patterns in men and women, such that mortality is highest in women residing in the least deprived areas and men residing in the most deprived areas. Systematic surveillance of lung cancer mortality by socio-economic status may facilitate the assessment of public health interventions aimed at mitigating cancer inequalities in Spain.
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