Poorest more likely to get cancer — and to die from it

Rachel Clun, The Independent

Cancer death rates are 60 per cent higher in the UK’s most deprived areas, new research shows, with the poorest more than 50 per cent more likely to be diagnosed after a trip to A&E than their wealthiest counterparts. A new report from Cancer Research UK has found that there are more than 28,000 extra cancer deaths a year linked to deprivation, and that people living in the poorest areas are up to a third more likely to wait more than 104 days to begin treatment despite an urgent referral. Those in the most deprived group are also less likely to take part in national screening programmes, and half as likely to receive cutting-edge treatment than people in the least deprived group. While cancer care for many has broadly improved over recent decades — last year more cancers were caught at earlier, more treatable stages than ever before — there are huge disparities in care, as the new research shows.

Dr Ian Walker, executive director of policy and information at Cancer Research UK, said cancer treatment and outcomes should be the same for everybody, regardless of their postcode or their income. “No one should be at a greater risk of dying from this devastating disease simply because of where they live. These figures are shocking and unacceptable — but crucially, they’re avoidable,” he said. Dr Neil Smith, GP lead for Lancashire and South Cumbria Cancer Alliance, has seen first-hand how difficult it can be for patients to access services. “High-quality care should be available to everyone when they need it. But sometimes, the hardest step can be getting to the doctor in the first place,” Dr Smith said. ‘You’re dead’: cancer fear driven by lack of awareness Norman Morse started fishing in the North Sea when he was 15, often spending extended periods out at sea to make his living.

The 70-year-old, who was diagnosed with bowel cancer after a colonoscopy in 2019, told The Independent that taking time off from a dangerous and labour-intensive job to see a doctor is a luxury people like him don’t have. “You’re self-employed, so any time you take off, well, that’s costing you money,” Morse said. “There’s pressure on fishermen to just get on with the job.” Morse said that, thanks in part to the “men are men” mentality of not talking about health issues, he had little understanding when he received his diagnosis of what it meant and what his options were. “What you actually hear is ‘You’re dead,’” he said. Morse said his actual outcome was “unbelievable” — his diagnosis and surgery were three years ago — and he now knows a lot more about cancer and its ramifications. “But there’s a whole load of the lads who are active fishermen who are fully unaware,” he added. That’s where C Aware comes in. It’s a trial programme being run through the maritime welfare charity Fishermen’s Mission to dispel cancer myths and stigmas among the fishing community while working with healthcare providers to bring cancer services to the quayside. Professor Peter Johnson, national clinical director for cancer at NHS England, said taking services to communities, rather than waiting for people to walk through the door, is vital to improving survival rates. “We need to keep thinking energetically about how we overcome those barriers, how we overcome the difficulties that people face in their everyday lives,” he said.

‘You can actually make a difference’ A key example of the problem, and its solution, can be seen in lung cancer. Nearly half (47 per cent) of the additional 28,400 cancer deaths a year linked to deprivation are caused by lung cancer, according to the Cancer Research UK report. NHS England has been working to tackle that issue through a lung screening programme that targets older people with a history of smoking who live in areas with high levels of deprivation and a high rate of death from the disease. That programme has helped to diagnose nearly 5,500 cases of lung cancer, and most were caught at an early stage. Prof Johnson said that because of that programme, people in the most deprived groups are now more likely to have their lung cancer diagnosed at an early stage.

“That’s really important, because it tells us that with a well-designed and properly resourced programme, you can actually make a difference,” he added. “The challenge for us in the next cancer plan is to work out how we do more of that, how we build on that experience, and how to take things to people, rather than waiting for people to come to us.” Health secretary Wes Streeting, who has recovered from kidney cancer and is overseeing the development of a new National Cancer Plan this year, said he knows “just how crucial timely diagnosis and treatment can be”.

“Our new targets for cancer diagnosis and treatment will mean around an extra 100,000 patients are seen on time next year, and we have also started using the latest digital AI technologies to help catch the disease earlier,” he added.