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Social Inequalities

Content overview

Download IARC Scientific Publication 168See the table of contents.

The volume “Reducing social inequalities in cancer: evidence and priorities for research” is structured according to the following major sections.

 

General considerations

Cancer is a disease of difference not only at the micro or molecular level but also at the macro or societal level. The large differences in cancer rates at the national and subnational scale reflect social inequalities and are a crucial public health issue. The global agenda to reduce social inequalities in cancer aligns perfectly with the United Nations Sustainable Development Goals. This volume serves as a foundation for collaborative research activities on social inequalities in cancer worldwide.

Part I. Evidence of social inequalities in cancer

Social inequalities in cancer incidence and mortality and in cancer risk factors are striking. Social inequalities occur at all stages of the cancer control continuum, i.e., information provision, etiology, prevention, early detection, diagnosis, treatment, survivorship, and palliative care. The phenomenon of inequalities in cancer affects everyone but has particularly negative repercussions for individuals with low socioeconomic position and other vulnerable groups (such as Indigenous populations, racial and ethnic minority groups, and refugees). The collection of appropriate indicators is essential to measure, and thus to monitor, social inequalities in cancer between and within countries, although information is often missing, especially in low-income countries and in disadvantaged individuals.

Part II. Mechanisms and context underlying social inequalities in cancer

Social epidemiological theories of disease distribution are critical to define and analyse cancer inequalities between social groups. A wide-ranging perspective needs to take into account the impact and dynamics of many contextual and societal mechanisms, including: the roles of income inequalities; the economics of and control policies for products such as tobacco, alcohol, food products, and sugar-sweetened beverages; national and international laws; and health systems. Life-course approaches can provide additional insights.

Part III. Tackling social inequalities in cancer

Moving beyond the description of the current status of evidence on social inequalities in cancer, there is a need to respond to the objective of tackling those inequalities. Concrete examples are provided of public health interventions that could reduce social inequalities in cancer in all settings. For instance, effective strategies can be put in place to reduce inequalities in tobacco consumption and tobacco-related cancers. Vaccination and screening are efficient to reduce social inequalities in certain cancers. In less-developed settings, low-cost approaches offer pragmatic solutions for tackling inequalities in major cancer types. Technological advances, such as those in diagnosis, surgery, and radiotherapy, may reduce or increase social inequalities in cancer, depending on whether they are introduced into the health-care system in a rational and affordable way.

Conclusions

Research priorities important for reducing social inequalities in cancer are summarized here. It is critical to continue generating the knowledge necessary to measure social inequalities in cancer, and to continue monitoring progress. Expansion of both research focused on prevention and investments in prevention is also needed, because prevention has the greatest potential for reducing social inequalities in cancer. Another key priority is to focus on equality when implementing and assessing any interventions and cancer control measures.



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