Socioeconomic inequalities in bladder cancer mortality in Canada: Temporal trends over three decades, 1990-2019

Bladder cancer is among the ten most deadly cancers in Canada. This study investigated income and education inequalities in bladder cancer mortality in Canada from 1990 to 2019.

A time-trend analysis using national data.

A census division level dataset (n = 280) was created using the Canadian Vital Statistics Death Database (1990 to 2019), the Canadian Census of Population (1991, 1996, 2001, 2006, 2016), and the National Household Survey (2011). Age-standardized relative and absolute Concentration index (RC and AC, respectively) was used to quantify the magnitude of income and education inequalities in bladder cancer mortality among males and females.

Crude bladder cancer mortality in Canada rose significantly from 1990 to 2019, increasing from 6.31 to 9.13 deaths per 100,000 population in males and from 2.79 to 3.90 in females. Persistent income- and education-related inequalities in bladder cancer mortality were observed, as age-standardized RC and AC indices were predominantly negative and statistically significant in several years. There was some evidence of change in income-related inequality over time, with indices suggesting widening inequality among females and only limited evidence of a modest reduction in inequality among males.

Bladder cancer mortality was higher among lower-income and less-educated Canadians, reflecting socioeconomic inequalities that may relate to incidence and treatment access. The observed variations in income-related trends across sexes highlight the importance of further research into sex-specific determinants of these inequalities.