Socioeconomic disparities in cancer outcomes remain a persistent challenges in public health. In their study “Decomposing educational inequalities in cancer mortality” Ineqkill members Joachim Gotinck and Sylvie Gadyne take a closer look at this issue by disentangling the complex relationship between cancer incidence and survival across educational groups.
Cancer is a leading cause of death in Belgium, but the risk is not shared equally. To tackle these disparities, we must identify their root: do vulnerable groups develop cancer more often, or do they face poorer outcomes after diagnosis?
The Study
We analyzed nationwide data linking the Belgian Census to cancer registry and mortality records (2004–2013). By focusing on educational attainment, we “decomposed” mortality inequalities into two drivers: incidence (how often cancer occurs) and survival (outcomes after diagnosis).
Key Findings
The results show that the “social gradient” varies significantly by cancer type and age:
- Incidence-Driven: For younger adults (30–49), inequalities are mainly driven by higher cancer occurrence, particularly for lung, stomach, and cervical cancer. Long cancer remains almost entirely incidence-driven across all ages.
- Survival-Driven: Among older adults (50–79), differences in survival become more prominent, especially for colorectal cancer.
- The Exception: Interestingly, breast cancer and melanoma occur more frequently among the highly educated, though mortality remains higher in lower-educated groups due to survival gaps.
Policy Impact
Prevention remains vital, but survival disparities highlight an urgent need for more equitable access to early diagnosis and high-quality treatment. By pinpointing whether the problem lies in prevention or healthcare, we can develop targeted interventions to ensure that a patient’s background no longer determines their chance of recovery.’
Read More
Full text of the article is available here.
Citation: Gotink, J., Verdoodt, F., & Gadeyne, S. (2026). Decomposing Educational Inequalities in Cancer Mortality: The Roles of Incidence and Survival in Belgium, 2004–2013. Social Science & Medicine, 119152. https://doi.org/10.1016/j.socscimed.2026.119152
