Income and education inequalities in ovarian cancer mortality in Canada: 1990–2019
Neha Katote1, Mohammad Hajizadeh2.
1Faculty of Medicine, Dalhousie Medical School, Halifax, NS, Canada; 2School of Health Administration , Dalhousie University, Halifax, NS, Canada
Health Equity and Policy Lab.
Introduction: Ovarian cancer ranks as the fifth leading cause of cancer deaths among Canadian women. While previous studies have investigated the socioeconomic gradient in ovarian cancer incidence, our understanding of socioeconomic inequality in ovarian cancer mortality within a pan-Canadian context remains limited. This study aims to investigate trends in socioeconomic inequalities in ovarian cancer mortality over the past three decades, from 1990 to 2019.
Methods: A dataset constructed at Census Division (CD, n=280) level in Canada using information from the Canadian Vital Statistics Death Database (CVSD), the Canadian Census of Population (CCP, 1992,1996, 2001, 2006, 2016) and the 2011 National Household Survey (NHS). Income and education inequalities in ovarian cancer mortality were measured using the age-standardized Concentration index (C). This index serves as a quantitative measure that assesses the extent of socioeconomic inequality within a specific sample size. Linear trend analysis was conducted by regressing ovarian cancer mortality and age-standardized C to examine statistically significant trends in ovarian cancer mortality over the three decades from 1990 to 2019.
Results: The average crude mortality rate for ovarian cancer in Canada was 9.7 per 100,000 people over the study, with British Columbia showing the highest average rate. The rate slightly increased in Canada over this period. Negative values of age-standardized C reached statistical significance in certain years, particularly in the recent period. This implies a higher prevalence of ovarian cancer in low socioeconomic groups in recent years. Trend analysis revealed a notable pattern of increasing income inequalities in ovarian cancer mortality over time.
Conclusion: The increase in ovarian cancer mortality among low-income Canadian women calls for more scrutiny. Further studies are required to identify the factors behind this trend in Canada.
This study is made possible through the data obtained from Canadian Vital Statistics Death Database, the Canadian Census of Population and the National Household Survey through the Atlantic Research Data Centre (ARDC) at Dalhousie University, which is part of the Canadian Research Data Centre Network (CRDCN). The authors are grateful to and would like to acknowledge the support of CRDCN in providing access to datasets. Further, we would like to thank Dr. Theresa Kim, ARDC analysis for her assistance and support of the research project..