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000168120 245__ $$aSmall-area analysis on socioeconomic inequalities in cancer survival for 25 cancer sites in Germany.
000168120 260__ $$aBognor Regis$$bWiley-Liss$$c2021
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000168120 520__ $$aSocioeconomic inequalities in cancer survival have been reported in various countries but it is uncertain to what extent they persist in countries with relatively comprehensive health insurance coverage such as Germany. We investigated the association between area-based socioeconomic deprivation on municipality level and cancer survival for 25 cancer sites in Germany. We used data from seven population-based cancer registries (covering 32 million inhabitants). Patients diagnosed in 1998-2014 with one of 25 most common cancer sites were included. Area-based socioeconomic deprivation was assessed using the categorized German Index of Multiple Deprivation (GIMD) on municipality level. We estimated 3-month, 1-year, 5-year and 5-year conditional on 1-year age-standardized relative survival using period approach for 2012-2014. Trend analyses were conducted for periods between 2003-2005 and 2012-2014. Model-based period analysis was used to calculate relative excess risks (RER) adjusted for age and stage. In total, 2,333,547 cases were included. For all cancers combined, 5-year survival rates by GIMD quintile were 61.6% in Q1 (least deprived), 61.2% in Q2, 60.4% in Q3, 59.9% in Q4, and 59.0% in Q5 (most deprived). For most cancer sites, the most deprived quintile had lower 5-year survival compared to the least deprived quintile even after adjusting for stage (all cancer sites combined, RER 1.16, 95% confidence interval 1.14-1.19). For some cancer sites, this association was stronger during short-term follow-up. Trend analyses showed improved survival from earlier to recent periods but persisting deprivation differences. The underlying reasons for these persisting survival inequalities and strategies to overcome them should be further investigated.
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000168120 650_7 $$2Other$$aArea-based socioeconomic deprivation
000168120 650_7 $$2Other$$aGermany
000168120 650_7 $$2Other$$acancer registry
000168120 650_7 $$2Other$$asurvival
000168120 7001_ $$0P:(DE-He78)810dd5ca5d284a355124f982bfc3a8e6$$aBehrens, Gundula$$b1$$udkfz
000168120 7001_ $$aMaier, Werner$$b2
000168120 7001_ $$aSchwettmann, Lars$$b3
000168120 7001_ $$aPritzkuleit, Ron$$b4
000168120 7001_ $$aHolleczek, Bernd$$b5
000168120 7001_ $$aKajüter, Hiltraud$$b6
000168120 7001_ $$aGerken, Michael$$b7
000168120 7001_ $$aMattutat, Johann$$b8
000168120 7001_ $$aEmrich, Katharina$$b9
000168120 7001_ $$0P:(DE-He78)bbfe0ebad1e3b608bca2b49d4f86bd09$$aJansen, Lina$$b10$$udkfz
000168120 7001_ $$0P:(DE-He78)90d5535ff896e70eed81f4a4f6f22ae2$$aBrenner, Hermann$$b11$$udkfz
000168120 7001_ $$aGroup, German Cancer Survival Working$$b12$$eCollaboration Author
000168120 7001_ $$aMöller, Mark$$b13
000168120 7001_ $$aJäger, Karin$$b14
000168120 7001_ $$aWerner, Carmen$$b15
000168120 7001_ $$aStrecker, Paul$$b16
000168120 7001_ $$aGerken, Michael$$b17
000168120 7001_ $$aGeiss, Karla$$b18
000168120 7001_ $$aTwardella, Dorothee$$b19
000168120 7001_ $$aMeyer, Martin$$b20
000168120 7001_ $$aEberle, Andrea$$b21
000168120 7001_ $$aLuttmann, Sabine$$b22
000168120 7001_ $$aWilsdorf-Köhler, Heide$$b23
000168120 7001_ $$aStabenow, Roland$$b24
000168120 7001_ $$aErb, Cynthia$$b25
000168120 7001_ $$aNennecke, Alice$$b26
000168120 7001_ $$aHentschel, Stefan$$b27
000168120 7001_ $$aSirri, Eunice$$b28
000168120 7001_ $$aKieschke, Joachim$$b29
000168120 7001_ $$aHolleczek, Bernd$$b30
000168120 7001_ $$aEmrich, Katharina$$b31
000168120 7001_ $$aKajüter, Hiltraud$$b32
000168120 7001_ $$aMattauch, Volkmar$$b33
000168120 7001_ $$aKatalinic, Alexander$$b34
000168120 7001_ $$aPritzkuleit, Ron$$b35
000168120 7001_ $$aMattutat, Johann$$b36
000168120 7001_ $$aArndt, Volker$$b37
000168120 7001_ $$aMaier, Werner$$b38
000168120 7001_ $$aSchwettmann, Lars$$b39
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000168120 7001_ $$aFinke, Isabelle$$b43
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