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AJPH First Look, published online ahead of print Mar 29, 2007
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November 2007, Vol 97, No. 11 | American Journal of Public Health 2082-2087
© 2007 American Public Health Association
DOI: 10.2105/AJPH.2005.073429

RESEARCH AND PRACTICE

Changes in Socioeconomic Inequalities in Cancer Mortality Rates Among French Men Between 1968 and 1996

Gwenn Menvielle, PhD, Annette Leclerc, PhD, Jean-François Chastang, PhD, Maria Melchior, PhD, Danièle Luce, PhD for the Evolution Des Inégalités Sociales Par Causes Médicales de Décès (Trend in Social Inequalities by Cause of Death) group

At the time of the study, the authors were with the National Institute of Health and Medical Research, Saint-Maurice, France.

Correspondence: Requests for reprints should be sent to Gwenn Menvielle, INSERM, U687-IFR69, HNSM, 14, rue du Val d’Osne, 94415 Saint-Maurice, France (e-mail: gwenn.menvielle{at}st-maurice.inserm.fr).

Objectives. We investigated changes in socioeconomic inequalities in cancer mortality rates among men in France between 1968 and 1996.

Methods. We used a representative sample of 1% of the French population and studied 4 periods (1968–1974, 1975–1981, 1982–1988, and 1990–1996). Causes of death were obtained by direct linkage with the French national death registry. The socioeconomic position of men aged 35 to 59 years was measured by using the occupational class reported at the time of the census at the beginning of each period. Analyses were conducted for all cancers and specifically for lung, upper aerodigestive tract, esophageal, colorectal, and other cancers.

Results. In all analyses, we observed socioeconomic inequalities during the 4 periods considered; the inequalities increased between the first and the last period. Most of the total increase occurred between 1968 and 1981, and inequalities remained stable thereafter. Inequalities were larger when men out of the labor force were included in the analysis. The strongest increase in socioeconomic inequalities over time was observed for upper aerodigestive tract cancer.

Conclusions. Although cancer mortality rates have decreased, substantial socioeconomic inequalities in cancer mortality among men remain.






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