The social determinants of cancer: the case of Eastern Morocco

The article focuses on the links between cancer and socio-demography and socio-economy from an epidemiological point of view. The relative contribution of various risk factors in the frequency of these cancers significantly demonstrated inequalities. A large part of the paper is devoted to a description of cancer according to socioeconomic, demographic and geographic levels, and to the locations of the dominant cancers in Eastern Morocco. Social inequalities in the field of cancer are particularly important. A total sample of 6428 cases of various cancers detected at the Regional Center of Oncology of Oujda was analyzed between years 2005 and 2010. Women were dominant with 4317 persons (67%) versus men with 2111 persons (33%). Most of these cancers were found in the two large cities of the eastern region, namely Oujda and Nador, and mainly affected the poor, most of which (80%) were out of work and generally over the age of 41. Among the cancers listed, those in southern cities were fewer than those of other cities. Several determinants were noted for their connection with cancer, including socio-economic wealth, cultural level, lifestyle, genetic and environmental situations. Reduced levels of exposure to certain risk factors, especially in disadvantaged groups, ought to reduce the inequalities in incidence, and hence inequalities in mortality. At the same time, a better information on the inequalities in healthcare in the broadest sense (including early detection), would help identifying successful interventions for reducing social inequalities in cancer prevalence. This implies that the social situation of patients, specifically the level of education or socio-professional category, be systematically documented. People with higher income and education levels are more likely to participate in cancer screening.