The Nova Scotia Community Cancer Matrix: Small-Area Spatiotemporal Estimation of Local Patterns of Cancer Co-occurrence, Risk and Inequity

Cancer is a major contributor to the global burden of disease impacting people worldwide. Incidence and mortality rates are expected to increase for the next two decades. In line with global trends, Canada projects a 40% increase in new cases and a 44% increase in cancer deaths between 2020 and 2040. Cancer prevention offers a cost-effective and sustainable strategy for global cancer control. Prevention must consider the cancers affecting local communities and understand how community and individual factors interact. The Nova Scotia Community Cancer Matrix profiles the cancers impacting communities in Nova Scotia, Canada, over time; measuring associations with socioeconomic status and identifying the joint distribution of cancers. The study reports on 99,094 cancers diagnosed in 301 communities between 2001 and 2017, across 22 cancer types. In addition to demonstrating the utility of geospatial methods to map disparities in cancer, the study reveals significant inequities rooted in the differential distribution of material and social capacity, operating beyond the control of individuals. Socioeconomic status not only influences the risk of developing a certain type of cancer, but also the risk of co-occurring cancers. The study demonstrates the importance of using small-area analysis to inform and strengthen cancer prevention efforts.