Keratinocyte carcinomas, area-level socioeconomic status and geographic remoteness in Tasmania: cross-sectional associations and temporal trends

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Ragaini, Bruna S
Blizzard, Leigh
Baade, Peter
Venn, Alison
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2023
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Abstract

Objective This article aims to examine cross-sectional associations and assess temporal trends in keratinocyte carcinoma (KC) incidence by area-level socioeconomic status (SES) and geographic remoteness in Tasmania, Australia.

Methods KCs—basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (SCC)—registered by the Tasmanian Cancer Registry were assigned to area-level SES and remoteness area. Incidence rate ratios (2014–2018) were estimated using Poisson regression. Average annual percentage changes (2001–2018) were estimated using the Joinpoint Regression Program.

Results BCC incidence increased with increasing area-level advantage (p value for trend <0.001), but no trend was found for SCC. SCC incidence was higher in rural than urban areas (p value <0.001), and BCC incidence was slightly lower in rural than urban areas for males (p value = 0.026), but not for females (p value = 0.381). BCC and SCC incidence increased between 2001 and the mid-2010s, when it peaked across most areas.

Conclusions Associations were found between BCC and higher area-level SES, and between SCC and geographic remoteness. The findings suggest differences in sun exposure behaviours, skin cancer awareness and access to services, or ascertainment bias.

Implications for public health Efforts to control and deliver KC services in Tasmania should consider targeting populations with specific area-level characteristics.

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Australian and New Zealand Journal of Public Health

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47

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4

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© 2023 The Authors. Published by Elsevier B.V. on behalf of Public Health Association of Australia. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Epidemiology

Health services and systems

Public health

Science & Technology

Life Sciences & Biomedicine

Public, Environmental & Occupational Health

skin cancer

basal cell carcinoma

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Ragaini, BS; Blizzard, L; Baade, P; Venn, A, Keratinocyte carcinomas, area-level socioeconomic status and geographic remoteness in Tasmania: cross-sectional associations and temporal trends, Australian and New Zealand Journal of Public Health, 2023, 47 (4), pp. 100067

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