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Cancer incidence in urban, rural, and densely populated districts close to core cities in Bavaria, Germany

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Abstract

Objective

An ecologic study on the level of districts was performed to evaluate the possible association between district type and risk of cancer in Bavaria, Southern Germany.

Methods

Cancer incidence data for the years 2003–2012 were obtained from the population-based cancer registry Bavaria according to sex and cancer site. Data on district type, socio-economic area deprivation, particulate matter exposure, tobacco consumption, and alcohol consumption were obtained from publicly available sources. The possible association between district type and cancer risk adjusted for age, socio-economic area deprivation, particulate matter exposure, tobacco consumption, and alcohol consumption was evaluated using multivariable multi-level negative binomial regression.

Results

We found a significantly reduced cancer risk in densely populated districts close to core cities and/or rural districts compared to core cities with respect to the cancer sites mouth and pharynx (women only), liver (both sexes), larynx (both sexes), lung (both sexes), melanoma of the skin (both sexes), mesothelioma (men only), connective and soft tissue (both sexes), corpus uteri, other urinary tract (men only), urinary bladder (both sexes), and non-Hodgkin lymphoma (both sexes).

Conclusion

Our findings require further monitoring. Since the apparently increased cancer risk in core cities may be related to lifestyle factors, preventive measures against lifestyle-related cancer could be specifically targeted at populations in deprived core cities.

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Abbreviations

95%-CI:

95% confidence interval

BIMD:

Bavarian Index of Multiple Deprivation

CLDM:

Age-adjusted mortality rate per 100,000 persons per year (European standard population) with respect to chronic liver disease

LCM:

Age-adjusted mortality rate per 100,000 persons per year (European standard population) with respect to lung cancer

DPOC:

Densely populated outer conurbation

HPV:

Human papillomaviruses

ICD-10:

International Statistical Classification of Diseases and Related Health Problems (Tenth Revision)

ICD-O-3:

International Classification of Diseases for Oncology (Third Edition)

PM-10:

Ambient pollution with particles with a diameter of 10 µm or less (µg/m3)

RR:

Risk ratio

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Acknowledgements

The authors wish to express their gratitude towards all patients, doctors, dentists, regional cancer registries, and towards the confidentiality office of the Bavarian cancer registry for providing and processing the cancer notifications that were used as the basis for this study.

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Authors and Affiliations

  1. Centre for Early Cancer Detection and Cancer Registration, Bavarian Health and Food Safety Authority, Schweinauer Hauptstr. 80, 90441, Nuremberg, Germany

    M. Radespiel-Tröger, K. Geiss, D. Twardella & M. Meyer

  2. Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany

    W. Maier

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  1. M. Radespiel-Tröger
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Correspondence to M. Radespiel-Tröger.

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Radespiel-Tröger, M., Geiss, K., Twardella, D. et al. Cancer incidence in urban, rural, and densely populated districts close to core cities in Bavaria, Germany. Int Arch Occup Environ Health 91, 155–174 (2018). https://doi.org/10.1007/s00420-017-1266-3

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