Methods
European and German studies assessing the association of socioeconomic status (SES) and cancer incidence as well as survival are reviewed.
Results
Incidence of lifestyle associated cancers shows an inverse association with SES, while screening-detectable tumors are more frequently diagnosed in people with a high SES, although the two are not mutually exclusive. Survival rates are positively correlated with SES for almost all tumor sites. These associations can be shown independently for several aspects of SES such as education, type of work and housing. Such effects are likely to be mediated by factors including unhealthy lifestyle, late stage diagnosis, low participation in screening programs and, most strongly, severity of comorbidity. Universal health insurance and targeted national cancer plans in European countries have often brought larger improvements for affluent strata than for deprived groups.
Conclusions
The need for measures which improve cancer prevention, detection and therapy for socioeconomically deprived individuals persists and needs to be addressed.