United Kingdom: excess cancer mortality of 60% among the most deprived

A report by Cancer Research UK highlights significant social inequalities in cancer in the UK. Higher prevalence of risk behaviours among disadvantaged people is compounded by inequalities in cancer diagnosis and treatment. Despite efforts, little progress has been made, with cancer mortality around 60% higher among disadvantaged populations than among advantaged populations.[1].

Three times more smokers and twice as many obese people among the most disadvantaged

According to the report, the incidence of cancer is significantly higher among disadvantaged populations, reflecting an inequality in the prevalence of the main risk factors. For example, in England, the smoking prevalence of the least advantaged quintile was 22% in 2023, more than three times that of the most advantaged quintile (6%). Similarly, obesity appears to be a real social marker in the United Kingdom: in Scotland, more than one in three disadvantaged adults is considered obese (36%), almost twice as many as among the most advantaged Scots. While social inequalities have reduced for several cancers in men, the opposite trend is observed in women. Furthermore, social inequalities in the face of lung cancer have widened over the years, while it represents 47% of fatal cancers. Indeed, the incidence of lung cancer is two and a half times higher among the most disadvantaged populations than among the more advantaged populations. Inequalities in diet and sports can also explain the differences in the incidence of cancers. However, Cancer Research UK's observation is not new: in 2006, a study by The Lancet showed that half of the gap in life expectancy between rich and poor was explained by social inequalities in smoking.[2].

Less screening and less easy access to care

The report also notes the persistence of social inequalities in cancer screening, which is essential for rapid treatment and an increase in the chances of survival. A significant gap is observed in particular between the least advantaged and the most advantaged people in participation in cancer screening programs, whether for example for cervical cancer (15 points), breast cancer (10 points) or intestinal cancer (19 points). To date, data on such inequalities for lung cancer are still unavailable. The most disadvantaged people also suffer from a later diagnosis than others, which is explained in particular by a lower recognition of symptoms and a less systematic recourse to medical consultation. Finally, access to treatment is also subject to inequalities, since disadvantaged patients are 33% more likely to wait more than 104 days before receiving treatment, while being half as likely to receive modern treatments for lung cancer. Ultimately, all of these elements translate into excess mortality among disadvantaged populations, since cancer mortality is approximately 60% higher among the most disadvantaged quintile.

FT

[1] Cancer Research UK, Cancer in the UK 2025: Socioeconomic deprivation, 02/2025, (accessed 02/24/2025)

[2] Jha P, Peto R, Zatonski W, Boreham J, Jarvis MJ, Lopez AD. Social inequalities in male mortality, and in male mortality from smoking: indirect estimation from national death rates in England and Wales, Poland, and North America. Lancet. 2006 Jul 29;368(9533):367-70. doi: 10.1016/S0140-6736(06)68975-7. PMID: 16876664.