Worrying new research shows cancer survival is worse in poorer areas of Scotland

What are the reasons behind the difference in survival rates?

The explanations for these differences warrant more research and attention politically. The explanations for inequalities in survival are undoubtedly complex and relate to several factors that could be grouped as patient, treatment, and tumour factors.

Patient factors include risk behaviours such as smoking, but also general fitness and other co-existing [heath] conditions. Tumour factors relate to the fact that different cancer sites, subsites and types also have different survival outcomes. And finally, treatment or healthcare system factors also play a part – early detection (screening service access and uptake), as well as the nature and quality of treatment and care can also play an important role.

It is worth noting that people play a role in seeking out services, but the healthcare system also plays an important role in ensuring availability, accessibility, and navigability. The inverse care law [that those who most need medical care are least likely to receive it] is still observed in relation to both cancer screening services and primary care services, where those from the most socioeconomically deprived backgrounds are least likely to access these services.

Any final thoughts?

The causes of socioeconomic inequalities in cancer outcomes are fundamentally social and economic. There is nothing mysterious in what creates social and economic circumstances - it is policies and politicians. So, the solutions are in their hands. Or rather they are in our hands when we cast our vote in elections.

Professor David Conway was involved with the International Agency for Research on Cancer publication investigating the evidence in relation to inequalities in cancer which explored the international evidence on this topic in detail.