Neighbourhoods matter too: the association between neighbourhood socioeconomic position, population density and breast, prostate and lung cancer incidence in Denmark between 2004 and 2008
- 1Unit for Health Promotion Research, Institute of Public Health, University of Southern Denmark, Denmark
- 2Department of Cancer Prevention and Documentation, Danish Cancer Society, Copenhagen, Denmark
- 3Center for Alcohol and Drug Research, Copenhagen Division, Aarhus University, Copenhagen, Denmark
- 4Institute for Biostatistics and Clinical Epidemiology, Charité—University Medicine Berlin, Germany
- Correspondence to Mathias Meijer, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 1353 Copenhagen K, Denmark;
Contributors MM contributed to conception and design, acquisition of data, analysis and interpretation of results, drafting and finalising the manuscript. GE contributed to design, acquisition of data, interpretation of results, drafting and finalising the manuscript. KB contributed to conception, interpretation of results, revising and finalising the manuscript.
- Accepted 27 May 2012
- Published Online First 23 July 2012
Background Previous studies have shown that cancer incidence is related to a number of individual factors, including socioeconomic status. The aim of this study was to refine the current knowledge about indicators associated with cancer incidence by evaluating the influence of neighbourhood characteristics on breast, prostate and lung cancer incidence in Denmark.
Methods All women aged 30–83 years were followed for breast cancer between 2004 and 2008, men between 50 and 83 years were followed for prostate cancer and both sexes between ages 50 and 83 were followed for lung cancer. Registry data obtained from Statistics Denmark included age, sex, availability of breast cancer screening, marital status, education, disposable income and occupational socioeconomic status on the individual level and population density and neighbourhood socioeconomic status (the proportion of unemployed) on the parish level. Frailty modelling with individuals on the first level and parishes on the second level was conducted.
Results A significantly lower HR of breast cancer was found in areas with low population density (HR=0.93; CI 0.88 to 0.99), while neighbourhood unemployment had no effect. Inhabitants of lower unemployment areas had a higher risk of prostate cancer (HR=1.14; CI 1.08 to 1.21) compared with those in higher unemployment areas, whereas population density had no effect. Risk of lung cancer was lower in areas with lowest population density (HR=0.80; CI 0.74 to 0.85) and lowest in areas with lowest unemployment (HR=0.88; CI 0.84 to 0.92).
Conclusions In addition to individual-level factors, characteristics on the neighbourhood level also have an influence on breast, prostate and lung cancer incidence.
- Small-area analysis
- risk factors
- residence characteristics
- cancer: breast
- cancer: cervix
Funding This work was supported by the Danish Council for Independent Research, Medical Sciences grant number 271-06-0549 and the Danish Health Insurance Foundation grant numbers 2007B048 and 2009B077.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.