Lung Cancer Incidence and Survival in England: An Analysis by Socioeconomic Deprivation and Urbanization

Introduction: Most previous studies have investigated either socioeconomic deprivation or urbanization in relationship to lung cancer incidence or survival. We investigated the association between socioeconomic deprivation, urbanization, and lung cancer incidence and survival in England. Methods: We extracted data on patients diagnosed with lung cancer (ICD-10 C33-C34) between 2003 and 2007 and who were resident in England. We assigned each patient to an urbanization score and to a socioeconomic quintile based on their postcode of residence. We calculated age-specific and age-standardized incidence rates (per 100,000 European standard population) by urbanization, sex, and socioeconomic deprivation group. We used Kaplan-Meier survival analysis to compare the survival of patients from urban and rural areas by socioeconomic deprivation. Results: A high proportion of urban areas in England were classified as deprived and rural areas were mostly affluent. The incidence of lung cancer was higher in urban areas than in rural areas. In the more affluent areas, the incidence of lung cancer in urban and rural areas was very similar. Survival from lung cancer was slightly higher in affluent areas than in deprived areas. Survival from lung cancer in urban and rural areas was similar across all socioeconomic deprivation quintiles. Conclusions: The difference in incidence between urban and rural areas can be explained by the differences in the distribution of socioeconomic deprivation quintiles in the two urbanization categories. When socioeconomic deprivation is taken into account, little difference is seen between both the incidence and survival of lung cancer in urban and rural areas.