发达国家许多癌症部位的年龄标准化癌症发病率在过去的几年中有所下降。这些趋势是否导致了癌症发病率的社会经济不平等的缩小或扩大，目前尚不清楚。本研究使用覆盖德国4800万居民的癌症登记数据，研究了2007年至2018年期间的年龄标准化总体和具体部位（结直肠、肺、前列腺和乳腺）癌症发病率与区域层面的贫困指数（分为五分位数）之间的生态关联。使用泊松模型比较了最贫困和最富裕地区的发病率。使用Joinpoint回归分析评估了平均年百分比变化（AAPCs）和贫困五分位数间AAPCs的差异。不考虑贫困水平，2007年至2018年期间总体癌症和所有癌症部位的年龄标准化发病率明显下降（除了女性肺癌）。然而，贫困分位数之间趋势变化的差异导致了总体癌症、结直肠癌和肺癌的不平等在时间上的增加。对于总体癌症，在男性中，最贫困分位数与最富裕分位数之间的发病率比值从1.07（95%置信区间：1.01-1.12）增加到1.23（1.12-1.32），在女性中从1.07（1.01-1.13）增加到1.20（1.14-1.26）。肺癌的不平等最为严重，2018年最贫困地区的发病率比最富裕地区高出82%（男性）和88%（女性）。癌症发病率不平等的增加与危险因素患病率和筛查利用率的不平等趋势一致。急需针对社会经济贫困和城市地区的干预项目。© 2023 The Authors. International Journal of Cancer由John Wiley & Sons Ltd代表UICC出版。

Age-standardized cancer incidence has decreased over the last years for many cancer sites in developed countries. Whether these trends led to narrowing or widening socioeconomic inequalities in cancer incidence is unknown. Using cancer registry data covering 48 million inhabitants in Germany, the ecological association between age-standardized total and site specific (colorectal, lung, prostate and breast) cancer incidence in 2007 to 2018 and a deprivation index on district level (aggregated to quintiles) was investigated. Incidence in the most and least deprived districts were compared using Poisson models. Average annual percentage changes (AAPCs) and differences in AAPCs between deprivation quintiles were assessed using Joinpoint regression analyses. Age-standardized incidence decreased strongly between 2007 and 2018 for total cancer and all cancer sites (except female lung cancer), irrespective of the level of deprivation. However, differences in the magnitude of trends across deprivation quintiles resulted in increasing inequalities over time for total cancer, colorectal and lung cancer. For total cancer, the incidence rate ratio between the most and least deprived quintile increased from 1.07 (95% confidence interval: 1.01-1.12) to 1.23 (1.12-1.32) in men and from 1.07 (1.01-1.13) to 1.20 (1.14-1.26) in women. Largest inequalities were observed for lung cancer with 82% (men) and 88% (women) higher incidence in the most vs the least deprived regions in 2018. The observed increase in inequalities in cancer incidence is in alignment with trends in inequalities in risk factor prevalence and partly utilization of screening. Intervention programs targeted at socioeconomically deprived and urban regions are highly needed.© 2023 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.