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Trends in socioeconomic inequalities in breast cancer mortality in Canada: 1992–2019

  • Epidemiology
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Abstract

Purpose

Breast cancer is the second leading cause of death from cancer among Canadian females. This study aimed to quantify and assess trends in education and income inequalities in the mortality rate of breast cancer in Canada from 1992 to 2019.

Methods

We constructed a census division-level dataset pooled from the Canadian Vital Death Statistics Database (CVSD), the Canadian Census of the Population (CCP), and the National Household Survey (NHS) to examine trends in education and income inequalities in the mortality rate of breast cancer in Canada over the study period. The age-standardized Concentration index (C) was used to quantify income and education inequalities in breast cancer mortality over time.

Results

The national crude mortality rate of breast cancer has decreased in Canada from 1992 to 2019, with Alberta, British Columbia, Manitoba, Ontario, Prince Edward Island, and Quebec having the greatest decreases in mortality rate. The age-standardized C for education and income inequalities were always negative for all the study years, meaning that the mortality rate of breast cancer was higher among less-educated and poorer females. Moreover, the results indicate a growing trend in the concentration of breast cancer mortality among females with lower income and education from 1992 to 2019.

Conclusion

The increasing concentration of breast cancer mortality among low socioeconomic status females remains a challenge in Canada. Continuous efforts are needed within Canadian healthcare system to improve the prevention and treatment of breast cancer for this population.

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Data availability

The datasets utilized in this study are accessible from the CRDCN.

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Acknowledgements

We conducted the analyses at Statistics Canada’s Atlantic Research Data Centre (ARDC) at Dalhousie University, which is part of the Canadian Research Data Centre Network (CRDCN). The authors would like to express their gratitude to the CRDCN for facilitating the access to the the Canadian Vital Death Statistics Database, the Canadian Census of the Population, and the National Household Survey, as well as to the ARDC analyst Theresa Kim for her support. We also thank the reviewer of the journal for the insightful suggestions and comments, which have significantly improved the manuscript.

Funding

Nazanin Nasiri acknowledges the Beatrice Hunter Cancer Research Institute Summer Studentship Award. Min Hu acknowledges the support of the University of British Columbia’s Start-up Grant. Mohammad Hajizadeh is supported by a Tier II Canada Research Chair in Health Economics through the Canada Research Chairs (CRC) Program (grant # CRC-2020-00219; https://www.chairs-chaires.gc.ca/home-accueil-eng.aspx).

Author information

Authors and Affiliations

  1. School of Health and Human Performance, Dalhousie University, Halifax, Canada

    Nazanin Nasiri

  2. Department of Economics, Philosophy, and Political Science, University of British Columbia, Okanagan Campus, Kelowna, Canada

    Min Hu

  3. School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2Nd Floor, Halifax, NS, B3H 4R2, Canada

    Mohammad Hajizadeh

Authors
  1. Nazanin Nasiri
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Contributions

Mohammad Hajizadeh and Nazanin Nasiri contributed to the conception and design of the study. Min Hu created the linked dataset. Mohammad Hajizadeh assisted with the data preparation and conducted the analysis. The first draft of the paper was written by Nazanin Nasiri. Mohammad Hajizadeh and Min Hu reviewed and revised the draft. All authors reviewed and gave their approval to the final version of the manuscript.

Corresponding author

Correspondence to Mohammad Hajizadeh.

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Conflict of interest

The authors report no conflict of interest.

Ethical approval

The datasets used in this study were obtained from the CRDCN, which follows strict disclosure protocols according to the Statistics Canada Acts and does not require review by a research ethics board, as per Tri-council policy statement: Ethical conduct for research involving humans (TCPS2) article 2.2.

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Nasiri, N., Hu, M. & Hajizadeh, M. Trends in socioeconomic inequalities in breast cancer mortality in Canada: 1992–2019. Breast Cancer Res Treat 205, 533–543 (2024). https://doi.org/10.1007/s10549-024-07277-y

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