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Largest ever UK study identifies social, ethnic discrepancies in lung cancer diagnosis

Oxford scientists conducted the largest ever UK study on lung cancer diagnoses that has revealed severe social and ethnic disparities, marking a significant step towards improving healthcare inequalities.  

The study found that people from the most deprived areas were twice as likely to develop lung cancer than those from the most affluent areas. Furthermore, people from deprived areas had a 35% higher risk of being diagnosed with more aggressive forms of the disease. 

Conducted by Oxford’s Nuffield Department of Primary Care Health Science, it included over 17.5 million people and more than 84,000 cases, making it the most comprehensive study into lung cancer in the UK.  

Research leader Daniel Chen explained to Cherwell the reasons for this pattern: “This is likely due to a combination of factors: Higher smoking prevalence in these [deprived] communities, greater barriers to healthcare access, and increased exposure to environmental risks (poor air quality, exposure to secondhand smoke, etc).” 

Ethnic disparities were also identified, such as Bangladeshi men showing the highest lung cancer rates. A correlation between type of diagnosis and ethnicity was also discovered: Women were more likely to be diagnosed, as well as those identifying as BAME were twice as likely to be diagnosed with adenocarcinoma than those identifying as white. The researchers believe this highlights the role of genetic predisposition in lung cancer.

The study was published as the NHS releases its Targeted Lung Health Check Programme, which aims to detect cancer earlier, when it is more treatable, by focusing screening on areas of social deprivation.  

The new research also highlights the need to consider other aspects of identity, the report stating: “[Taken] together, our results have implications not only for targeting smoking prevention and cessation interventions in an accessible way, but also ensuring equitable delivery of the new lung cancer screening programme especially for women, those from ethnic minority groups and deprived areas to avoid exacerbating health inequalities.” 

Chen told Cherwell: “There has been a research gap in understanding the role of ethnicity in cancer, not specifically within the NHS but more generally. This is largely due to the under-representation of ethnic minority groups in research, often resulting in small sample sizes and limited data for assessing impacts across these populations.” 

He explained that, while previous research has considered ethnicity as a factor, it has nonetheless been insufficient due to regional focus and limited samples. In this Oxford study, however, researchers used QResearch data from over 1,000 practices and more than 10 million patients, enabling a “comprehensive, nationwide view” of these disparities.

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