Childhood leukaemia and socioeconomic status in England and Wales 1976-2005: evidence of higher incidence in relatively affluent communities persists over time

Br J Cancer. 2011 Nov 22;105(11):1783-7. doi: 10.1038/bjc.2011.415. Epub 2011 Oct 25.


Background: Record-based studies have generally reported association of higher childhood leukaemia incidence with higher socioeconomic status (SES), but recent findings are less consistent.

Methods: We examined records from the National Registry of Childhood Tumours for evidence of this association in England and Wales during 1976-2005. All eligible leukaemia registrations (N=11940) were grouped by year of diagnosis in decades centred on census years 1981, 1991 and 2001 (N=3748, 3922, 4270, respectively). Using data from the census appropriate to the decade, SES for each case was measured by the child-population-weighted quintile of the Carstairs deprivation index of the census ward containing the address at diagnosis.

Results: In each decade, the age-standardised leukaemia rate in the poorest quintile was ∼90% of the rate in the most affluent. Using Poisson regression, the age-adjusted rate ratio per quintile decrease in SES was 0.96 (95% confidence interval 0.94-0.98; P<0.001 for trend) in 1976-1985, 0.97 (0.95-0.99; P=0.008) in 1986-1995 and 0.97 (0.95-0.99; P=0.009) in 1996-2005. Similar association was evident for lymphoid leukaemia, the major subgroup (N=9588 in total), but not for acute myeloid (N=1868) or other/unspecified leukaemia (N=484).

Conclusion: Reported childhood leukaemia incidence in England and Wales continues to be higher in relatively affluent communities. Possible explanations include under-diagnosis of leukaemia in children from poorer communities, and/or association of higher SES with hypothesised risk factors, such as population mixing and delayed exposure to infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Censuses
  • Child
  • Child, Preschool
  • England / epidemiology
  • Humans
  • Infant
  • Infant, Newborn
  • Leukemia / economics
  • Leukemia / epidemiology*
  • Poisson Distribution
  • Registries
  • Residence Characteristics / statistics & numerical data*
  • Risk Factors
  • Social Class*
  • Wales / epidemiology