Thousands more cancer cases linked to deprivation

Thousands of extra cancer cases are linked to deprivation in Scotland, according to Cancer Research UK (CRUK).

The charity has found that around 4,900 extra cancer cases a year are linked, which equates to 13 cases a day.

Those living in the poorest areas are also more likely to be diagnosed at a later stage when cancer can be harder to treat successfully.  

Smoking is the biggest cause of cancer in Scotland and it continues to be far more common in deprived communities.

Nearly 7% of cancer cases each year in Scotland are caused by excess weight, making it the second biggest risk factor and those living in deprived areas are also more likely to be overweight or obese.

A report by CRUK found cancer death rates are 74% higher in the most deprived communities than the least deprived in Scotland.

The chief executive of Cancer Research UK, Michelle Mitchell, said it was "unacceptable" that people from deprived areas were more likely to die from cancer.

She said: "The Scottish government's forthcoming cancer strategy is a key opportunity to tackle cancer inequalities.

"People in Scotland need the strategy to be bold, ambitious and fully funded so no-one with cancer is disadvantaged because of where they live or due to financial pressures.

"Now is the time to go further and faster to ensure that beating cancer means beating cancer for everyone." 

CRUK researchers found that screening uptake is also far lower in more deprived communities.

Bowel cancer screening is 38% lower and breast cancer screening is 32% lower compared to in the least deprived areas.

Access to cancer treatment can also vary depending on where people live and receiving treatment can be more challenging for people living in rural areas.

'It doesn't discriminate'

Melanie Finlay is currently receiving chemotherapy treatment at Raigmore hospital in Inverness.

She lives in the city with her husband and eight-year-old son Joseph but she has faced several 200-mile round trips from Inverness to Aberdeen Royal Infirmary for appointments. 

She said: "It was a long journey, travelling to Aberdeen to be seen by a doctor, and we had to arrange for someone to pick Joseph up after school while we were away.   

"I've also met people who live in the countryside and have faced long, difficult journeys to access treatment."

Melanie was an admin officer for Police Scotland when she was first diagnosed with breast cancer in May 2018.

Having had surgery, chemotherapy and radiotherapy, she hoped to put the disease behind her. But when she experienced joint pains, she tried to get a GP appointment in December 2020.

Due to the pandemic, she faced a two-month wait and after seeing a physiotherapist, she was finally diagnosed with secondary breast cancer in March 2021, that had spread to her bones and was stage four.

She said: "Cancer affects all of us, it doesn't discriminate. 

"It is unfair if people living in one area or community in Scotland have less chance of surviving cancer because of who they are, where they live or barriers they face while trying to get treatment."

Three key actions to tackle cancer inequalities

In its report, CRUK has laid out three key actions to tackle cancer inequalities.

They include tackling the known drivers of cancer inequality, such as providing more support to reduce smoking and obesity in deprived communities.

The charity also wants to diagnose cancers earlier by enabling people to get timely access to health services, including screening.

Collecting routine data on patient characteristics would also help strengthen infrastructure, the charity believes, and build a stronger understanding of where inequalities exist.

 The Scottish government launched a written consultation on a new cancer strategy between April and June 2022, which sought views on which areas to prioritise in relation to cancer prevention, management and care.

The responses will be used to inform the drafting of the new 10-year cancer strategy and three year action plan to be published in the spring of 2023.

There are multiple reasons why people in the poorest communities are more likely to get cancer and to have it diagnosed late.

Some of it is linked to lifestyle, with higher rates of smoking and obesity; but it also comes down to things like having to choose between going to work or going to the GP, or the cost of taking two buses to a hospital appointment.

These deterrents are well-known and are considered unfair and avoidable. The call from charities like Cancer Research UK is that to fix it greater investment is needed - not simply in staff or diagnostic equipment that will improve outcomes for everyone - but in targeted efforts to reduce rates of smoking, still far higher in deprived communities, or making it much easier to access treatment.

But almost a quarter of those referred after a suspicion of cancer waited longer than the 62 day target to start treatment and there are backlogs in screening because of the pandemic. These issues are affecting everyone, but for the least well-off - it means extra barriers to accessing help.