Influence of Income on Cancer Incidence and Death among Patients in Aomori, Japan

Document Type : Research Articles


1 Department of Medical Informatics, Hirosaki University Graduate School of Medicine, Japan.

2 Department of Medical Informatics, Hirosaki University Hospital, Japan.


Background: Aomori Prefecture has experienced the highest cancer-related mortality rates since the 2000s in Japan.
In addition, income of residents in Aomori Prefecture is lower than that of a countrywide average. Aims of this study
were to examine the relationships of the incidence and mortality rates of common cancers (stomach, colorectal, liver,
lung, breast, cervical, and prostate) with the income levels of residential income area and clarify the factors contributing
to the high mortality rates in Aomori prefecture.Methods: We included data on all patients diagnosed with stomach,
colorectal, liver, lung, breast, cervical, or prostate cancer in the Aomori cancer registry database between 2010 and
2012. Age-standardized incidence rates and incidence rate ratios were calculated. Risk of cancer mortality related to
economic disparities was determined via multivariable Cox regression analysis and adjusted for age, sex, and stage at
diagnosis in the multivariable model. Results: We identified 21,240 eligible cancer patients. There were no differences
in AIRs and IRRs among patients with stomach, colorectal, or lung cancer according to income. Contrarily, AIRs and
IRRs were higher in higher-income areas than in lower-income areas among patients with breast, cervical, or prostate
cancer. There were no significant differences in HRs according to income for any cancer type. Conclusions:Patients
with higher income were diagnosed with early-stage disease more frequently, and they had higher AIRs for breast,
cervical, and prostate cancers than those with middle and low incomes. However, there were no significant differences
in hazard ratios.




Main Subjects

Volume 19, Issue 11
November 2018
Pages 3193-3202
  • Receive Date: 27 April 2018
  • Revise Date: 07 September 2018
  • Accept Date: 18 October 2018
  • First Publish Date: 01 November 2018