New research by Cancer Research UK has snown that there are 2,000 extra cancer cases a year linked to deprivation in Wales, which equates to more than five avoidable cases a day. Research also found that lung cancer is responsible for around half of these extra cases, with almost 1,000 lung cancer cases linked to deprivation. Cancer death rates are 55% higher in the most deprived populations than the least deprived in Wales.
Smoking – the biggest cause of cancer in Wales, with around 3,100 cases caused by the habit, continues to be far more common in deprived areas. People living in more deprived areas are also more likely to be overweight or obese, which is the second biggest risk factor for cancer after smoking. Around 1,000 cancer cases each year in Wales are caused by excess weight.
Meanwhile, screening uptake is far lower in more deprived communities. Breast cancer screening is 19 percentage points lower and bowel cancer screening is 15 percentage points lower in the most deprived populations compared to the least deprived. A similar trend is seen for cervical screening, with screening 12 percentage points lower for people from more deprived populations than the least deprived.
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On top of this, access to cancer treatments can vary greatly depending on where people live in Wales. For example, receiving treatment can be more challenging in rural areas due to difficulties with public transport, or patients needing more time off work for regular appointments to allow for journey time.
According to Cancer Research UK, early diagnosis remains key to beating cancer but found people from deprived backgrounds are less likely to know the signs and symptoms of cancer and face greater barriers to contacting their GP if they have noticed any changes.
The statistics come as part of a landmark report by a cross-party group of Members of the Senedd, which was published on Thursday. The ‘All Things Equal’ inquiry into cancer inequalities in Wales showed that those living in the poorest areas of the country are more at risk of developing cancer and are more likely to be diagnosed at a later stage when cancer can be harder to treat successfully.
The Senedd Cross-Party Group on Cancer and Cancer Research UK led the inquiry which includes evidence from cancer patients, clinicians, charities and researchers. It has now called for drastic improvements by the Welsh Government and NHS Wales to tackle cancer inequalities.
Recommendations in the inquiry include rolling out interventions that tackle known drivers of inequalities, diagnosing cancers earlier and ensuring everyone has access to the right treatments for them, strengthening data collection, infrastructure and access, and investing in research and innovation into cancer inequalities.
A huge financial burden
A dad-of-five from Cardiff has spoken about the financial burden of cancer. Lewis Griffiths, from Llandaff North, was diagnosed with Hodgkin Lymphoma, which is a type of blood cancer, in January 2022.
The 33-year-old started chemotherapy straight away and the side-effects meant he had to stop working as a self-employed plumber. Since then, Lewis and his family have been deeply affected by the illness, both physically and emotionally, as well as financially.
According to Lewis, the cancer has meant that not only has he had to give up work, but also paying rising energy bills, household budget and a mortgage on the house he shares with his wife Sharon, his three children and two step-children have also been hit.
Prior to his diagnosis, Lewis Griffiths admitted he was the type to just “get on with it” and would instead concentrate more on his work than getting any symptoms checked out. He started getting symptoms in the summer, but still refused to see a GP.
As well as a lump, Lewis said he experienced itchiness, night sweats and weight loss. When discussing the symptoms, he said: “I was so itchy at the time and put that down to hay fever and thought the lump and night sweats were glandular fever,” said Lewis. I’d also been training at the gym so thought that’s why I was losing weight.”
It took almost six months for Lewis to go to the GP, after his family finally persuaded him to go. Lewis said: “I was shocked when I had my diagnosis. I thought I was too young to be seriously ill and had no idea my symptoms were cancer.”
According to Lewis, he has struggled to pay his mortgage and household bills, which has not helped by the cost-of-living crisis. He also admitted that things got so bad that he refused to turn the heating on until his children returned home from school.
Lewis said: "I remember sitting in a blanket, freezing cold, feeling rubbish after treatment and I wanted to save what was left on the meter for when the children got back from school.”
Lewis felt he had no other option but to start working again, but he soon had to stop as he was in pain and fatigued from treatment. He said: “I was exhausted from chemo but tried to keep working to provide for my family.
“Even lifting a bag of cement was difficult and treatment caused numbness in my hands which meant putting a bathroom together was really difficult. I wanted to work but just couldn’t do it.”
He added: “I just wanted to concentrate on getting better but the money situation was so hard, and it was really stressful. No-one talks about the impact cancer has on finances and it feels like there is no support from the Welsh Government to help people financially when they go through cancer.”
A fundraising page has been set up to help Lewis and his family. The fundraiser has drawn £8,399 in donations towards a £9,000 target. He is now waiting for more tests after responding well to a second phase of treatment, including a bone marrow transplant.
Lewis said: “We’ve been overwhelmed by people’s generosity. The money raised has meant we have been able to pay our bills and buy food, and we were also able to buy the kids Christmas presents.”
He added: “Am looking forward to being able to get back to work and hopefully there will be a holiday on the cards for the family sometime next year.
“I’ve definitely changed after having cancer. I used to smoke 15 to 20 cigarettes a day, but I’ve stopped smoking now as I want to be as healthy as I can.
“I just think the Welsh Government needs to do more to look after people when they are going through cancer. Having cancer is hard enough, without having to worry about money as well. Beating cancer should be beating cancer for all.”
Calling for urgent action by the Welsh Government to improve cancer survival for all, Cancer Research UK’s senior external affairs manager in Wales, Andy Glyde, said: “It is unacceptable that people in Wales are more likely to get cancer and die from cancer if they live in an area of higher deprivation.
“The Welsh Government recently announced a new cancer plan for Wales, and it must now be delivered in a way that tackles inequalities. We can only succeed in our mission of beating cancer if everyone affected by the disease has the same chances. Now is the time to go further and faster to ensure that beating cancer means beating cancer for everyone.”
Chair of the Cross-Party Group on Cancer, David Rees MS, said: “Some of the results of our inquiry have been truly shocking. Our report shines a light on unacceptable health inequalities facing patients and we are calling for urgent action to ensure everyone has the same chance of beating cancer.
“We are grateful to everyone who has participated to the inquiry which identifies some of the potential solutions to address cancer inequalities. It will require all of us to work together – Welsh Government, Senedd Members, NHS Wales, third sector, researchers, and other bodies – if we are to make a difference.”
In response, a spokesperson for the Welsh Government said: "We are committed to addressing health inequalities and improving cancer services and survival rates. We fund a number of projects to improve public health, including our Health Weight Healthy Wales strategy and Tobacco Control strategy, as well as our broader work to address poverty and risk factors such as air pollution. We will consider the recommendations in the report."
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