Study of socio-economic inequalities in the incidence of colorectal cancer in 1396: A comparative investigation of Iranian provinces

By 2020, colorectal cancer accounted for 10% of global cancer incidence and 9.4% of cancer deaths. Apart from biomedical characteristics, socio-economic status can also play a role in inequality in the outcomes of this disease. In this account, this study aims to analyze the regional socio-economic disparities in the incidence of colorectal cancer in Iran.

This cross-sectional study was executed using provincial data from 2018. The required information was extracted from the report of the statistical yearbook, the report of the Statistics Center, and the national report of the National Cancer Registration Program of the Ministry of Health of Iran. Using STATA 14, concentration indices were estimated and concentration curves were extracted.

Only the concentration index of health insurance coverage percentage and employment percentage was negative. The effect of health insurance coverage on inequality in cancer incidence (CI=-0.364) was also statistically significant (P<0.05). The results showed that per capita income has caused the most inequality (CI=0.632) in the incidence of colorectal cancer (P<0.05). While the effect of provincial employment percentage on incidence inequality was the lowest (CI=-0.064) and was not statistically significant. After per capita income, the per capita expenditure concentration index (CI=0.564) was in second place in terms of inequality (P <0.05). The literacy rate with CI=0.484 was in the next rank of inequality (P<0.05).

Socioeconomic characteristics of the provinces have an important role in the inequality of colorectal cancer. Policymakers can improve early detection of the disease in the country's provinces by covering screening services with medical insurance, providing screening credit cards, payment exemptions for the lower deciles, and social marketing.