Deprivation and cancer incidence in a de-industrialised and highly ageing area. [Deprivazione e incidenza di cancro in un’area ex-industriale a forte invecchiamento].

Abstract Aims: The analysis by tumor site, age groups and gender of the 1999-2003 cancer incidence in Genoa province population clusters in relationships with the socio-economic (SE) deprivation, evaluating if the observed associations confirmed the literature. Methods: The SIR of all malignant cancers (but not melanoma skin cancers) and 35 sites were computed by deprivation cluster, gender and age groups (all ages, 0-64, 65+ years), evaluating the variance in SIR among groups. The SE clusters were individuated by the Genoa Deprivation Index (GDI), derived from the re-parameterisation of the LRDI (Liguria Region Deprivation Index) inside the territorial limits of Genoa province. Results: All malignant cancers combined showed no association with deprivation in both sexes due to a balance of positive and negative observed associations. Increasing trend at decreasing deprivation (linear negative associations) regarded colon, melanoma, skin carcinomas, breast, prostate, meningioma and myelodysplastic syndromes, while the opposite (linear positive associations) were observed for oropharynx, oesophagus, stomach, rectum, liver, lung, mesothelioma, uterine corpus, testis, kidney, brain, Hodgkin’s and non-Hodgkin’s lymphomas and myeloma. Conclusions: The combined effects of population ageing, de-industrialisation and increasing role of touristic activities in Liguria induced a situation forerunner of the possible post-industrial Western countries development outcomes. Our study confirmed some known associations between deprivation and cancer incidence occurrence: both the positive with smoke- and alcohol-consumption (oropharynx, oesophagus, lung) and infectious risks (rectum, liver) and the negative ones with diet, obesity and sedentariness (colon, breast, prostate) and sun recreational exposure (skin carcinomas, melanoma). Also the controversial evidences regarding brain and haematological tumours seemed confirmed. From the future experiences of re-allocation of resources on the Genoa territory could derive input on readjustment policies on social and health resources redistribution at national level.