Evidence map›Paper›PMID 40890381›Full record

ArticleScientific reports2025

Widening socioeconomic inequalities in cancer incidence and related potential to reduce cancer between 2008 and 2019 in Germany.

Fabian Tetzlaff, Benjamin Barnes, Lina Jansen, Frederik Peters, Annemarie Schultz, Alexander Katalinic, Klaus Kraywinkel, Niels Michalski, Enno Nowossadeck, Jens Hoebel

Abstract read
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Social inequalities in cancer in Germany: a call to action.Journal of cancer research and clinical oncology · 2026
    Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Fabian TetzlaffDivision of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany. TetzlaffF@rki.de.
Benjamin BarnesGerman Centre for Cancer Registry Data, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
Lina JansenEpidemiological Cancer Registry of Baden-Württemberg, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Frederik PetersCancer Registry Hamburg, Hamburg, Germany.
Annemarie SchultzCancer Registry Hamburg, Hamburg, Germany.
Alexander KatalinicInstitute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany.
Klaus KraywinkelGerman Centre for Cancer Registry Data, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
Niels MichalskiDivision of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany.
Enno NowossadeckDivision of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany.
Jens HoebelDivision of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background Cancer is one of the main causes of a high burden of disease and one of the strongest contributors to earlier mortality among lower socioeconomic groups in Germany. Therefore, studying socio-economic inequalities in cancer incidence is of high relevance from a public-health and health-equity lens. The aim of this study was to examine in more depth time trends in socioeconomic inequalities in cancer incidence and the related potential for reducing the incidence of specific cancers across Germany. Methods We used epidemiologic data from the Centre for Cancer Registry Data at the Robert Koch Institute and official population statistics for Germany from 2008 to 2019. To analyse trends in socioeconomic inequalities in cancer incidence, we used an ecological study design and linked the cancer registry and population data with the German Index of Socioeconomic Deprivation at district level. We calculated standardised cancer incidence rates for the most common cancers by area-level socioeconomic deprivation and estimated the Slope and Relative Index of Inequality (SII, RII) to determine the extent of area-level socioeconomic inequalities in the risk of cancer. In a what-if analysis, counterfactual scenarios were used to calculate how much lower cancer incidence could be if socioeconomic inequalities in incidence were reduced or eliminated. Results Due to less favourable trends of cancer incidence in more deprived areas, socioeconomic inequalities in cancer incidence has widened to the detriment of residents in highly deprived areas. This was observed for all cancers combined and for several common cancers such as stomach, colorectal and lung cancer among both women and men. In 2017-19, total cancer incidence was 18% (women: RII 1,18) and 49% (men: RII 1,49) higher in the most than in the least deprived area. Reverse inequalities were observed for skin melanoma in both sexes and female breast cancer, the lowest incidence being among residents of highly deprived districts. For 2017-19, the what-if analysis showed that the annual number of newly diagnosed cancers cases would be 9,100-76,000 cases fewer if the socioeconomic gap in cancer incidence between districts could be narrowed or eliminated. Conclusions In Germany, socioeconomic inequalities in cancer incidence have widened in recent decades. Tackling cancer risks in deprived areas could reduce those inequalities and the burden of cancer overall. Our study emphasises the growing importance of structural approaches in cancer prevention for reducing health inequalities in Germany.

Indexed as

Health Status DisparitiesNeoplasmsSocioeconomic FactorsAdultAgedFemaleGermanyHumansIncidenceMaleMiddle AgedRegistriesArea-level socioeconomic inequalitiesDeprivationGermanyGISDSocial determinantsTrends cancer incidence

Identifiers

PMID40890381
PMCPMC12402129

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