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Logo of bmjThis ArticleThe BMJ
 
BMJ. 2007 November 24; 335(7629): 1068–1069.
PMCID: PMC2094197

Cancer incidence among young is higher in England's wealthier areas

In England the South East had the highest incidence of cancer among teenagers and young adults, a new study shows, while the North East had the lowest. And there was a trend for cancer incidence in this age group to be lower in local wards with greater deprivation, it found.

The study, which involved more than 35 000 people aged 13 to 24, gives details of the incidence of specific cancers in the nine Government Office Regions in England and according to levels of deprivation in the census ward of residence of patients at the time of diagnosis (British Journal of Cancer 2007;96:1760-6 doi: 10.1038/sj.bjc.6603794). It shows that cancers in this age group were more common in less deprived areas (P for trend <0.001).

“These cancer incidence patterns differ from those seen in both children and older adults and have implications for aetiology and prevention,” the authors write.

They say that although previous studies have looked at variability in the incidence of cancer at different ages in Britain, the fact that cancer is more likely to occur in middle aged and elderly people (more than 75% of cancers are in people aged over 60) has masked patterns of disease among young people.

The study used data from all nine regional cancer registries in England from 1979 to 2001 to look at variability in the incidence of cancer by region and deprivation score of census ward (as measured by the Townsend deprivation index) among people aged 13 to 24.

The results showed that 35 291 cases of cancer occurred in 186 million person years at risk, giving an overall incidence of 188 cases per million person years at risk. The incidence varied from 173 in the North East to 208 in the South East and South West.West.

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Although there was a significant trend towards a lower incidence with increasing deprivation, the patterns of incidence varied by diagnostic group.

The incidence of leukaemia, particularly that of chronic myeloid leukaemia, was highest in the most deprived areas, but no significant trends were shown in the incidence of acute lymphoblastic leukaemia or myeloid leukaemia.

“There is consistent evidence of a role for infections in leukaemia in young children, but other factors such as traffic density and benzene exposure should be explored [in this age group], especially in densely populated areas with high leukaemia incidence, such as London and the South East,” says the report.

The incidence of lymphoma fell as deprivation increased, a trend that was largely due to Hodgkin's lymphoma, which was also higher in the four regions in the south of England than in the Midlands and the north.

The incidence of germ cell tumours and melanoma was highest in the least deprived wards. This, says the report, was entirely due to the incidence of testicular tumours, which accounted for 85% of cases in this group of cancers. The South West region had the highest incidence. The incidence of melanoma in the least deprived areas was almost double that in the most deprived areas.

The highest incidence of carcinoma of the cervix was found in the most deprived areas.


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