Health inequalities are causing 33,000 avoidable cases of cancer in the UK every year, a damning analysis suggests.
Ministers have promised for years to tackle differences in health outcomes as part of their declared mission to level up the country. But their long-promised white paper on health inequalities has been ditched and the junk food advertising ban on TV and the web has been delayed until October 2025.
Spending on public health grants has also been reduced by about a fifth since 2015, amounting to real-terms cuts of almost £800m. This has meant cuts to vital schemes that promote better health and reduce the risk of cancer, including reducing smoking and losing weight.
An analysis by Cancer Research UK, seen by the Guardian, estimates there are 33,000 extra cases of cancer in the UK each year associated with deprivation. These could be avoided if health inequalities were tackled, the charity says.
Dr Ian Walker, the executive director of policy and information at Cancer Research UK (CRUK), said there was clearly a “real issue” with fairness. He added: “It should not, in this day and age, be that your likelihood and outcome of a cancer diagnosis is significantly impacted by where you live, how much money you’ve got, what your background is. It really shouldn’t. There’s a real injustice to this. It’s a really important problem that we’re trying to help move in the right direction.”
Lung cancer is the leading cause of the extra cases linked to deprivation, largely because smoking is much more common in more deprived areas. People in routine and manual occupations in England are about 2.5 times more likely to smoke than people in managerial and professional occupations, CRUK said. There are nearly twice as many cancer cases caused by smoking in the poorest areas than in the wealthiest in England.
People living in more deprived areas are also more likely to be overweight or obese, which is the second biggest preventable risk factor for cancer after smoking.
CRUK developed the analysis using the indices of multiple deprivation model, which is based on geographical area. Excess cases were estimated by comparing the number of cases that actually occurred in deprived areas with the number of cases there would be if everyone had the same incidence rates as people in the least deprived parts of the country.
It estimated that there are 33,000 extra cases of cancer in the UK each year linked with deprivation. Nearly one in 10 (9.1%) cancer cases were associated with deprivation, the charity’s analysis found.
Health inequalities owing to deprivation mean that, on average, more than 90 people in the UK are diagnosed with an avoidable cancer every day.
“If everybody in the country had the same outcomes, then they’re avoidable,” said Walker. “If we didn’t have inequalities across risk factors, if we didn’t have inequalities across signs and symptoms awareness, if we didn’t have inequalities across access to primary and secondary healthcare, then they’re avoidable.”
He added: “It’s a fairly significant picture and something we need the government and the health system to start addressing.”
Data suggests people from the most deprived communities are less aware of cancer symptoms and also report more barriers to seeking help – the most common being getting an appointment at a time that works for them. Because of these obstacles, people may find it difficult to seek help or put off doing so until the disease reaches a crisis point.
People from more deprived areas are not only more likely to get cancer, they are more likely to be diagnosed at a late stage for certain cancer types and have trouble accessing cancer services. They are also more likely to die from the disease.
Walker said he was disappointed that the government chose to launch a major conditions strategy last year, rather than having a standalone cancer strategy. “Whilst that is still an important process … we are concerned that that probably won’t go far enough in terms of turning the tide for [cancer] survival and certainly in terms of addressing these inequalities,” he said.
The government said it was committed to levelling up the health of the nation so that everyone could live longer, healthier lives.
A Department of Health and Social Care spokesperson added: “We are tackling the causes of preventable cancers, announcing a £40m pilot to give eligible patients access to effective obesity drugs and providing £70m of additional new funding for local authority stop smoking services. We are also expanding cancer screening programmes and asking more people to come forward for checks.
“Our major conditions strategy will also set out further plans to tackle the main causes of ill-health, including cancer.”