Background

Age-standardised cancer incidence rates are typically higher in more deprived populations compared to less deprived populations in the UK. England is the only UK nation not to provide routine updates for age-standardised cancer incidence rates by deprivation group. The latest available incidence by deprivation breakdown for England is from 2006-2010, and an update is required using the latest available data.

Method

Cancer incidence by deprivation data (2013-2017) was provided by Public Health England upon request, and population by deprivation data (2013-2017) was provided by the Office for National Statistics. Each data set was split by sex and five-year age band, with the cancer data additionally split by International Classification of Diseases version 10 (ICD-10) 3-digit code. Quintiles of the Income domain from the Index of Multiple Deprivation 2015 (IMD 2015) measure were used for both cancer incidence and population estimates. The age-standardised incidence rates were calculated using the 2013 European Standard Population. The number of excess cases was calculated using age-specific crude incidence rates.

Results

Age-standardised incidence rates for all cancers combined (excluding non-melanoma skin cancer) in England are 16% and 19% higher in the most deprived quintile compared to the least for females and males, respectively. Around 16,800 cases of all cancers combined are linked with deprivation (around 7,100 in females and around 9,800 in males). Of the 36 cancer types studied, the majority displayed higher incidence rates in the most deprived quintile compared to the least deprived quintile. The inverse is true for a selection of cancer types (e.g. female breast), with higher incidence rates displayed in the least deprived quintile compared to the most deprived.

Conclusion

The present analysis provides a necessary update on the socio-economic variation in cancer incidence in England. With an exception of a few cancer types, there is a clear deprivation gap for cancer incidence, with higher cancer rates in more deprived populations. Causes for this deprivation gap are multi-faceted, but differences in risk factor prevalence and screening uptake between deprivation groups are probably implicated.

Impact statement

This evidence should galvanise efforts to reduce socio-economic inequalities in factors related to the prevention and diagnosis of cancer.