Who you are and where you live affects your chances of getting, and surviving, cancer
As part of a series of cycles of loss, supported by a philanthropic grant from the Paul Ramsay Foundation, we published three articles on the social determinants of health. They looked at how factors such as your income, where you live, and your background influence your risk of cancer, dementia and heart disease.
In Australia, the odds of living for at least five years after being diagnosed with cancer have increased from 51% to 70% over the past 30 years. But not everyone has the same opportunities.
Likewise, your risk of developing cancer differs depending on where you live, how wealthy you are, and your parents’ wealth and social situation.
How does your socioeconomic group affect your cancer risk?
If you live in a socially disadvantaged area – defined by the low salaries of a largely unskilled workforce, high unemployment, and low levels of education – you have a 5% higher chance of developing cancer than those living in an area that most benefited. Your survival also tends to be 20% lower if you get cancer.
Why?
Some of the differences are that those with fewer resources are more likely to have a lifestyle with more cancer risk factors when compared to those who benefit the most.
Read more: Salary, zip code and parents affect your heart disease risk
The least fortunate are three times more likely to smoke tobacco than the most benefited, and more likely to be obese due to a lack of access to good nutrition and green space to exercise.
Disadvantaged groups are also less likely to participate in cancer screening. These programs help detect cancer before symptoms appear (if it is more curable). Precancerous lesions may also be removed to prevent the development of cancer.
Some of the differences are because those in the lowest socioeconomic groups have fewer resources to access health care and cancer prevention. They may be less able to take time off work to see a doctor and seek treatment, less able to afford scans and prescription medications, and less able to take preventive measures such as eating lots of fresh vegetables or sunscreen to wear every day.
How does where you live affect your cancer risk?
Losses were also found in those living in remote areas. There may be fewer job opportunities and less income. People in remote areas may have less access to a general practitioner and must travel for diagnostic tests and treatment.
Although for some types of cancer such as lung, head and neck cancer, and cervical cancer, the incidence is higher in very remote and remote areas, the overall cancer risk is lower than in other areas when all cancers are combined.
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The Australian Cancer Atlas provides details by zip code. This should be reviewed carefully so that adjustments are made in suburbs with an older population that will have more cancer because cancer is more common with age.
When this is done, several “hot spots” reveal other causes of cancer. For example, the north coast of New South Wales has a high incidence of melanoma. The possible cause is that the people there spend more time on the beach and outdoor activities that are exposed to the sun. However, living in a suburb with a healthy environment and plenty of opportunities to exercise outside can reduce the risk of other cancers, such as colon cancer.
Read more: Salary, zip code and parents affect your heart disease risk
Some associations are more difficult to explain.
While breast cancer rates tend to be high in disadvantaged areas, some affluent suburbs also have high rates. Here, the explanation may be that many professional women are pursuing careers and putting off having children until later in life, which puts them at a higher risk of breast cancer than women who have children at a younger age.
Who your parents are and where you come from affects your cancer risk
Many lifestyle factors that increase the risk of cancer can be changed. But the risk may start back from your parents. Putting genetics aside and inheriting cancer-causing genes, your family’s ethnicity and lifestyle can also affect your risk of cancer.
An estimated 30% of Australians were born overseas. In general, they are healthier than adults born in Australia, but their chances of developing cancer increase over time as they adopt the Australian diet and lifestyle.
Those born abroad face challenges such as language and cultural barriers to accessing the health system. For example, fewer migrants participate in cancer screening programs.
The cancer rate for First Nations Australians is 1.7 times that of non-Indigenous Australians.
Some of this increased risk comes from living far away, but more than half the risk of developing cancer can be attributed to social and economic disadvantages.
This can be demonstrated in lifestyle factors such as a higher smoking rate, which is three times that of the general population. Obesity is also more common, with fresh fruit and vegetables often harder to come by in remote areas.
In addition to ethnic background and Indigenous status, who your parents are has other effects on your cancer risk. The education level of parents can influence health literacy – that is, their understanding of the health system and public health messages, the importance of prevention and screening, and healthy lifestyles.
Your parents’ attitude to introducing you to alcohol as a child, or their smoking behavior, may have set the pattern for your subsequent behavior. There is even some research showing parenting styles, such as being overprotective, are associated with an increase in cancer in males – although more research is needed to establish a connection and an explanation.
Identifying these risk factors is important in helping individuals, governments, and policymakers shape strategies to reduce the cancer burden.
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