P089 Socioeconomic deprivation and skin cancer incidence in Greater Manchester: a population-based cohort study

Abstract

Socioeconomic status (SES) influences skin cancer incidence and outcomes. Greater Manchester’s diverse population across its 10 boroughs offers a valuable setting to understand how SES may affect skin cancer epidemiology in the UK. We conducted a retrospective cohort study using data from the Greater Manchester Care Record, which contains longitudinal comprehensive primary care records across Greater Manchester’s 2.8 million population, to examine the relationship between SES and incident basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC) and malignant melanoma (MM). Area-level deprivation was defined using the Index of Multiple Deprivation; analyses used data from 2021 to 2022. Age-and-sex-standardized incidence ratios were calculated using English cancer registry data as the reference, and regression-based incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were modelled using negative binomial regression, adjusting for Greater Manchester’s 10 boroughs. Incidence rates (per 100 000 person-years) for BCC, cSCC and MM were 181/199, 61/56 and 31/33, respectively for 2021 and 2022. In fully adjusted models, BCC incidence increased with decreasing deprivation, with higher risk in the least deprived compared with the most deprived group (IRR 1.67, 95% CI 1.20–2.33; P-value for trend < 0.001). A similar pattern was observed for MM, where the incidence in the least deprived group was nearly threefold higher (IRR 2.88, 95% CI 2.39–3.47; P-value for trend < 0.001). No trend was observed for cSCC (IRR 1.15, 95% CI 0.86–1.54; P = 0.33). Incidence varied across Greater Manchester, with 1.5–2 times higher rates in Stockport and Wigan compared with Salford for all three cancers; compared with Manchester for MM; and compared with Trafford for BCC and cSCC, independently of SES, age and sex. We found higher incidences of BCC and MM, but not cSCC, in more affluent populations, and regional differences across Greater Manchester independently of SES. This may potentially reflect differences in sun-exposure behaviour, population skin phototype, health-seeking behaviour and access to care. Further research should aim to investigate the role of health inequalities on outcomes in people diagnosed with skin cancer.