The risk of dying of cancer in England varies hugely depending on where people live with northern cities such as Manchester among those with the highest risk
The analysis of mortality rates for 10 forms of cancer with the largest death toll for men and women, researchers found the risk of dying from cancer varies widely depending on which district in England patients live.
The findings, published in The Lancet Oncology, show that while at the national level the risk of dying from cancer before 80 years of age declined from 2002-2019 for both men and women, the highest risks were in northern cities such as Liverpool, Manchester, Hull and Newcastle, and in coastal areas to the east of London.
The risk for women dying from cancer before 80 years of age ranged from one in ten in Westminster to one in six in Manchester, while for men the risk ranged from one in eight in Harrow (Greater London) to one in five in Manchester.
Mortality risk was associated with poverty for both sexes, and the greatest inequality across regions was for cancers with risk factors such as smoking, alcohol and obesity, and for those which could be prevented or detected early by screening.
According to the researchers, the findings highlight stark inequalities across the country and an urgent need to strengthen national and local public health and screening programmes.
Professor Majid Ezzati, senior author of the study and Professor of Global Environmental Health at Imperial College London, said: “Although our study brings the good news that the overall risk of dying from cancer has decreased across all English districts in the last 20 years, it also highlights the astounding inequality in cancer deaths in different districts around England.”
Lung cancer was also one of the cancers with the most inequality in risk of dying across different districts, with women in Knowlsey in 2019 having triple the risk of dying from lung cancer than those in Waverley, and men in Manchester having triple the risk of dying from lung cancer than men in Guildford.
Theo Rashid, first author and PhD student at Imperial College London, said: “The greatest inequality across districts was for the risk of dying from cancers where factors such as smoking, alcohol and obesity have a large influence on the risk of getting cancer.
“Due to funding cuts, many local authorities have reduced their budgets for smoking cessation since 2010. Our data shows we cannot afford to lose these public health programmes and are in urgent need of the reintroduction and strengthening of national and local policies which combat smoking and alcohol.”
Professor Amanda Cross, study author and Professor of Cancer Epidemiology, Imperial College London, said: “Access to cancer screening and diagnostic services which can prevent cancer or catch it early are key in reducing some of the inequalities our study highlights.
“Those who are more deprived are less likely to be able to access and engage with cancer screening. To change this, there needs to be investment into new ways to reach under-served groups, such as screening ‘pop-ups’ in local areas like supermarkets and working with community organisations and faith groups.”
