Time trends in educational inequalities in cancer mortality in Colombia, 1998–2012

ObjectivesTo evaluate trends in premature cancer mortality in Colombia by educational level in three periods: 1998–2002 with low healthcare insurance coverage, 2003–2007 with rapidly increasing coverage and finally 2008–2012 with almost universal coverage (2008–2012).SettingColombian population-base...

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Bibliographic Details
Published in:BMJ open 2016-04, Vol.6 (4), p.e008985
Main Authors: de Vries, Esther, Arroyave, Ivan, Pardo, Constanza
Format: Article
Language:English
Subjects:
Adult
Age
Annual reports
Cancer
Cause of Death
Censuses
Colombia - epidemiology
Databases, Factual
Demography
Education
EPIDEMIOLOGY
Female
Health care policy
Health insurance
Humans
Insurance Coverage
Male
Middle Aged
Mortality
Mortality, Premature - trends
Neoplasms - mortality
Population
Public Health
Regression Analysis
Sex Distribution
SOCIAL MEDICINE
Socioeconomic Factors
Trends
Young Adult
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Summary:ObjectivesTo evaluate trends in premature cancer mortality in Colombia by educational level in three periods: 1998–2002 with low healthcare insurance coverage, 2003–2007 with rapidly increasing coverage and finally 2008–2012 with almost universal coverage (2008–2012).SettingColombian population-based, national secondary mortality data.ParticipantsWe included all (n=188 091) cancer deaths occurring in the age group 20–64 years between 1998 and 2012, excluding only cases with low levels of quality of registration (n=2902, 1.5%).Primary and secondary outcome measuresIn this descriptive study, we linked mortality data of ages 20–64 years to census data to obtain age-standardised cancer mortality rates by educational level. Using Poisson regression, we modelled premature mortality by educational level estimating rate ratios (RR), relative index of inequality (RII) and the Slope Index of Inequality (SII).ResultsRelative measures showed increased risks of dying among the lower educated compared to the highest educated; this tendency was stronger in women (RRprimary 1.49; RRsecondary 1.22, both p
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2015-008985