Cancer incidence inequality gap in Wales unchanged over two decades

People living in the most deprived areas of Wales continue to experience higher rates of cancer than those in the least deprived areas, new figures show.

The latest Cancer Incidence in Wales 2002–2022 report was published by the Welsh Cancer Intelligence and Surveillance Unit (WCISU) at Public Health Wales.

It reveals that in 2022, the cancer incidence rate was 20 percent higher in the most deprived fifth of the population compared with the least deprived fifth. This gap has remained largely unchanged since 2006.

Delayed diagnoses

The report also notes that while incidence dropped during the first full year of the COVID-19 pandemic in 2020, the number of cases in 2022 suggest a partial return to pre-pandemic trends and a rebound of delayed diagnoses in some cancer types. Over half of all new cancer cases in Wales in 2022 were in people aged 70 or older.

Between 2002 and 2022, the number of new cancer cases in Wales rose by almost a third, from around 16,000 to just over 21,000, mainly reflecting changes in the size of the population and the proportion of more elderly people living in Wales.

After accounting for the aging population and changes in population size, the cancer incidence rate only increased by 1.2% between 2002 and 2022.

The change reflects previous cancer risk factor patterns, such as smoking, obesity and alcohol, in different sections of our society caused by inequalities in socio-economic factors and other root causes of ill-health.

Risk factors

Professor Dyfed Wyn Huws, Director of the Welsh Cancer Intelligence and Surveillance Unit at Public Health Wales, said: “The overall number of people being diagnosed with cancer in Wales has increased over the past two decades. This is due to changes in population size, population age structure and previous patterns of cancer risk factors affecting different groups in society over time.

“However, the persistent gap in cancer rates between our most and least deprived communities remains concerning.”

The report has carried out new analysis of stage at diagnosis by area deprivation, showing that the level of area deprivation is associated with the stage at which cancer is diagnosed.

The rates of late-stage lung cancer and bowel cancer diagnoses were higher than early-stage across all levels of area deprivation. These differences were wider in the most deprived areas, especially for lung cancer.

Professor Huws added: “Preventing cancer and reducing inequalities in cancer rates requires tackling the root societal causes of risk factors that can lead to cancer.

“The reasons why people smoke, become overweight and obese, or drink too much alcohol, for example, are complicated, and fall outside of the health service.

“However, services do exist to help people deal with some of these issues once they occur, such as our ‘Help Me Quit’ and ‘Healthy Weight, Healthy You’ services. Some cancers, such as cervical cancer and some mouth and throat cancers, can easily be prevented by the effective HPV vaccine.”

‘Complicated’ 

Professor Huws continued: “Increasing rates of cancer early diagnosis is also complicated. WCISU at Public Health Wales took part in international studies to find out the reasons for the late diagnosis of cancer in our population.

“Attending screening appointments from Breast Test Wales, Bowel Screening Wales, and Cervical Screening Wales are effective ways of detecting cancer early, before any symptoms appear, so that effective treatment can be started early.

“It’s important to seek help straight away from your GP if you are worried about any troubling symptoms, such as blood in your poo, a new cough that won’t go away, or a lump in your breast or somewhere else on your body that you’re not sure about, for example. That way, you can get diagnosed or reassured sooner rather than later and start treatment that can be effective.”

For the first time, the report includes analysis on the incidence of neuroendocrine cancers and small cell lung cancer.

WCISU at Public Health Wales have shared that their aim was to establish a clear baseline for the future. As this is the first year of reporting, figures should be interpreted with caution, and analyses will be refined in the future.

More information about Public Health Wales can be found on their site.