British Bangladeshi men have the highest rates of lung cancer in England, according to a study that reveals clear patterns in how the disease affects different communities in the country.
Disparities that go beyond smoking have been revealed by the University of Oxford researchers’ analysis of 17.5 million people’s health records and 84,000 lung cancer cases.
The findings, from Oxford’s Nuffield Department of Primary Care Health Sciences, coincide with the rollout of the targeted lung health check programme across England, which aims to reach 40% of the eligible population by March 2025 and 100% by 2030.
The new research found “ethnic background and social circumstances” are crucial factors in cancer risk, how it develops, and the type.
Lung cancer occurred twice as frequently in the most deprived areas compared with the least – with 215 cases per 100,000 people among men in the poorest areas, compared with 94 cases in the most affluent, the study found.
For women, rates in the most deprived areas were at 147 per 100,000, compared with 62 in the least deprived.
Bangladeshi men showed the highest lung cancer rates, followed by white, Chinese and Caribbean men.
Women and people from Indian, Caribbean, Black African, Chinese and other Asian backgrounds were twice as likely to be diagnosed with adenocarcinoma, one of the most common types of lung cancer, said the paper, titled Ethnic disparities in lung cancer incidence and differences in diagnostic characteristics: a population-based cohort study in England, published in the Lancet Regional Health – Europe.
The study, spanning 2005 to 2019, adds to existing research that suggests disparities in lung cancer could be influenced by genetic predisposition and class as well as habits.
Dr Daniel Tzu-Hsuan Chen, who led the research, said: “This isn’t just about smoking: our research shows that ethnic background and social circumstances play crucial roles in both cancer risk and how the disease develops.”
Among those who developed lung cancer, people from deprived areas had a 35% higher risk of being diagnosed with more aggressive forms. The study found men and current smokers were more likely to be diagnosed at later stages than women and non-smokers.
In June last year, the then Conservative government announced the rollout of the targeted lung cancer screening programme, aimed at early detection and prevention across England. It involves people aged 55 to 74, registered with GPs and with a known history of smoking, assessed and invited for screenings and smoking cessation services, aiming to save thousands of lives and slash the cost to the NHS of late-stage treatment.
It follows a pilot, beginning in 2019, in which 900,000 people in parts of England were invited for checks, with more than 2,000 detected as having cancer and 76% of lung cancers caught early, compared with 29% before it began.
During the programme, screening took place in mobile units in places such as supermarket car parks, focusing on deprived neighbourhoods where people are four times more likely to smoke.
The Oxford researchers hope that, by highlighting how healthcare access, ethnicity and class affect cancer outcomes, their findings will help ensure checks reach those most at risk as the rollout continues.
Prof Julia Hippisley-Cox, a senior author of the study, said: “We need to ensure our cancer services are reaching all communities effectively and that everyone has the same opportunity for early diagnosis.
“Tackling these disparities isn’t just about lung cancer: when we address these fundamental inequalities in healthcare access and social deprivation, we can improve health outcomes across many conditions.”
