Inequalities in cancer
1.10 There are wide inequalities in who gets cancer. People from deprived and less affluent backgrounds are more likely to get some types of cancer and overall are more likely to die from it once they have been diagnosed.
In the early 1990s 17 professional men out of 100,000 would die of lung cancer, while the rate was 82 per 100,000 for unskilled workers.
1.11 There are wide variations in cancer incidence and mortality related to birthplace. Mortality rates for lung cancer are lower in groups born in the Caribbean, Asia and Africa and are higher in people born in Scotland and Ireland, whereas deaths from cervical cancer are more common in women born in the Caribbean.
1.12 There are a number of reasons for these inequalities in cancer. While genetic factors may have some part in explaining ethnic variations in incidence of cancers, different levels of exposure to key risk factors for cancer - notably smoking and diet - are very important. The affluent are less likely to smoke and tend to have more fruit and vegetables in their diet. Lower awareness of the symptoms of cancer in some social groups, later presentation to GPs, lower uptake of screening services and unequal access to high quality services also play a role.
1.13 There are also inequalities in the treatment patients receive depending on their age. Not all patients are suitable for all treatments and it can be dangerous to give some very frail patients aggressive treatment with harmful side- effects. But frailty and age are not the same thing and some 70 year olds are healthier than some 50 year olds. As within any other disease treated by the health service, ageism is unacceptable in NHS cancer services.
