New research by Cancer Council NSW has found that overall lung cancer incidence in NSW women increased between 1985 and 2009 – except for those living in the highest socioeconomic areas, where a decreasing trend was observed.
It is well known that there is a strong relationship between lung cancer incidence and smoking – about 80% of lung cancer cases are in people who smoked. Lung cancer trends closely mirror generational trends in smoking prevalence, with a general 20-30 year lag between population smoking patterns and subsequent lung cancer diagnosis.
There is also a known social gradient in smoking prevalence and lung cancer rates, with an inverse relationship between socioeconomic status and smoking or lung cancer rates: lung cancer incidence tends to be higher for lower socioeconomic groups within a population.
“The aim of our study was to build on what we know already – by using data collected over a long period of time,” Honorary Professor Dianne O’Connell, Senior Researcher at Cancer Council NSW, said.
“Our main finding was that lung cancer incidence trends in different socioeconomic areas were more or less the same between 1985 and 1995, but then started diverging,” Honorary Prof O’Connell continued.
Between 1985 and 2009, 9,840 women aged 25-69 were diagnosed with primary lung cancer in NSW. The overall incidence rates increased gradually over the 25-year period – from 19.8 cases per 100,000 women in 1985 to 25.7 in 100,000 in 2009. However, trends were not the same across all socioeconomic areas.
“While rates in the highest socioeconomic area more or less stabilised after 1995, they kept increasing in the lower socioeconomic areas. The highest total increase (55 per cent) was seen for the lowest ranked area,” Honorary Prof O’Connell said.
The increasing gap in lung cancer incidence between women in the highest socioeconomic area and all others shows that there is a continued need for the implementation of tobacco control interventions.
“Australia has come a long way – we’ve seen extremely successful tobacco control policies come into place since the 1970s. However, these initiatives may not always work equally well across all population groups,” said Scott Walsberger, Lead Prevention and Tobacco Control Manager at Cancer Council NSW.
Possible reasons for the divide include that those living in higher socioeconomic areas may be more responsive to public health campaigns, more likely to use effective resources for quitting smoking and have more restrictive home/work environments in terms of smoking.
“To ensure all socioeconomic groups benefit from a reduced smoking prevalence and ultimately see a decrease in lung cancer rates, we need to implement targeted tobacco control interventions.
“Disadvantaged smokers want to stop smoking, too. Cessation services should be tailored to these groups’ needs,” Mr Walsberger continued.
One such targeted intervention is Cancer Council NSW’s Tackling Tobacco program, a tobacco control initiative aimed at disadvantaged communities.
“Through Tackling Tobacco, Cancer Council NSW helps community service organisations address smoking – so that they can give their clients the support they need to quit, and to de-normalise smoking in the community,” Mr Walsberger concluded.