title: Associations between regional socioeconomic deprivation and cancer risk: Analysis of population-based Cancer Registry data from Bavaria, Germany.
abstract: OBJECTIVE
  Previous research from other countries shows a positive association between cancer risk and regional deprivation. This study explores this association for lung and colorectal cancers in Germany.
  
  
  METHODS
  Regional deprivation was assessed by the 'Bavarian Index of Multiple Deprivation'. Cancer data were provided by the Cancer Registry of Bavaria (2003-2006). The association between cancer risk and regional deprivation was evaluated by multilevel Poisson regression analysis.
  
  
  RESULTS
  Crude incidence and mortality rates (per 1000 people) in the least deprived areas were 1.46 and 0.92 for lung cancer, 2.82 and 0.69 for colorectal cancer. For lung cancer, the age-adjusted relative risk (RR) for incidence in the most deprived districts (compared with the least deprived) in men was 1.41 (95% CI: 1.28-1.54), for mortality 1.59 (95% CI: 1.40-1.80); in women, an elevated RR was seen for mortality (1.24, 95% CI: 1.06-1.46). For colorectal cancer, the RR for incidence (men: 1.31, 95% CI: 1.17-1.46; women: 1.25, 95% CI: 1.12-1.40) and mortality (men: 1.51, 95% CI: 1.28-1.80; women: 1.49, 95% CI: 1.26-1.77) was always highest in the most deprived districts.
  
  
  CONCLUSIONS
  At the district level in Bavaria, the risk for lung and colorectal cancers mostly increases with increasing regional deprivation.
authors.affiliation: German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany. laura.kuznetsov@med.uni-muenchen.de
authors.forename: Laura
authors.initials: L
authors.lastname: Kuznetsov
authors.forename: Werner
authors.initials: W
authors.lastname: Maier
authors.forename: Matthias
authors.initials: M
authors.lastname: Hunger
authors.forename: Martin
authors.initials: M
authors.lastname: Meyer
authors.forename: Andreas
authors.initials: A
authors.lastname: Mielck
mesh_terms: D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D011204:Poverty Areas; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors