Regional and socioeconomic inequalities in lung cancer mortality in Belgium, 2001-2009

Paulien Hagedoorn, Vrije Universiteit Brussel
Katrien Vanthomme, Vrije Universiteit Brussel

INTRODUCTION Lung cancer is a leading cause of cancer death. Belgian men have the highest lung cancer mortality in Europe. The association between lung cancer and socioeconomic status has been extensively studied. However, not much research has focused on regional differences in lung cancer mortality. Therefore, this study aims to examine regional and socioeconomic inequalities in Belgian lung cancer mortality. MATERIAL AND METHODS Data from the Belgian National Mortality Database, a unique dataset linking census and register data to death certificates were used. The study population comprises all inhabitants of the Belgian regions Flanders and Brussels during 2001-2009 aged 40+. Mortality by district is calculated using the age standardized mortality rate (ASMR), directly standardized to the 2001 population for Belgium. The role of individual socioeconomic status on lung cancer mortality is estimated using Poisson Regression while controlling for age, marital status and health status. RESULTS Lung cancer mortality for men and women aged 40+ is highest in the east of Flanders and is relatively low in the southeast. The exception is Brussels, where lung cancer mortality is relatively low for men but high for women. For men aged 40-64, higher lung cancer mortality is observed in the southwest of Flanders while lower mortality is found in the northeast. Overall, the effect of socioeconomic status is larger for women, and the largest effects are observed for the 40-64 age-category. Socioeconomic status has only minor effects on regional mortality differences. CONCLUSION Both regional and socioeconomic inequalities in lung cancer mortality exist within Flanders and Brussels. Regional mortality differences can only partly be explained by the individual socioeconomic status. As indicated by previous research, it is likely that area-level socioeconomic status and environmental factors are also of influence.Future research should explore the potential influence of these factors as well.