Cancer death risk higher in Scotland’s most deprived areas

The latest deprivation analysis from Public Health Scotland shows that the age- and sex-standardised cancer mortality rate was 397.2 deaths per 100,000 people in the most deprived fifth of Scotland during 2020 to 2024.

That compared with 227.7 deaths per 100,000 among those living in the least deprived fifth- a difference of 74.4%.

The data comes as earlier this year The Herald revealed that a gulf of more than three decades in healthy life expectancy separates Scotland’s most and least affluent neighbourhoods.

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The latest data shows inequality was particularly stark for cancers of the trachea, bronchus and lung.

The mortality rate for lung cancer was three-and-a-half times higher in the most deprived areas, at 123.1 deaths per 100,000, compared with 34.9 in the least deprived communities.

The figures also show that, while the risk of dying from cancer has fallen in both groups, progress has been substantially slower in Scotland’s poorest areas.

Between 2015 and 2024, the cancer mortality rate fell by 5.6% in the most deprived areas, from 418.1 to 394.9 deaths per 100,000.

In the least deprived areas, the rate fell by 14.5%, from 259.4 to 221.8 per 100,000, indicating that the inequality between the two groups has widened.

Public Health Scotland said people in deprived communities were more likely to develop cancers with lower survival rates, including lung cancer.

The agency said higher levels of additional health conditions could also prevent some patients from receiving more aggressive treatments, while uptake of breast, bowel and cervical cancer screening was lower in deprived areas.

Macmillan Cancer Support described the findings as “deeply concerning” and called for deprivation to be included as standard in routinely published cancer statistics.

Peter Hastie, External Affairs Manager Scotland at Macmillan Cancer Support said: “It is deeply concerning that too many people living in the most deprived areas of Scotland continue to experience poorer cancer outcomes. No one’s postcode or background should determine the care they receive or their chances of survival. Everyone deserves the best possible cancer care, no matter who they are or where they live.

“To tackle these unfair inequities, all routinely published cancer data should include a breakdown for deprivation as standard. This would give a clearer picture of where people are getting left behind and help drive action to ensure everyone receives high-quality cancer care.”

The Scottish Conservatives said the figures exposed a continuing “postcode lottery” in cancer outcomes and accused SNP ministers of failing to tackle health inequalities.

Scottish Conservative health and care spokesman, Miles Briggs MSP said: “These figures expose the stark reality that it is still a postcode lottery when it comes to surviving cancer in Scotland.

“Patients in our most deprived communities are being let down by years of SNP failure to tackle health inequalities, with progress on reducing cancer deaths lagging well behind that seen in more affluent areas.

“Instead of squandering ever more money into bureaucracy, ministers must get more resources to the frontline, expand early diagnosis and screening, and ensure patients receive treatment as quickly as possible.

“We also need cancer data to be routinely published with deprivation and ethnicity analysis so we can properly understand where inequalities exist and target support where it is needed most.

“Every patient deserves the same chance of surviving cancer, regardless of their postcode or background, and the SNP must finally outline a plan to clos these unacceptable gaps in outcomes.”

Scottish Labour also called for targeted measures to increase screening uptake and improve access to diagnostic technology in deprived communities.

Scottish Labour health spokesperson Jackie Baillie said: "It is deeply worrying that those living in the most deprived parts of Scotland continue to face a greater risk of dying from cancer than those in the least deprived areas.

“It is shameful that little progress has been made by the SNP Government in the last 20 years to improve the situation.

"We urgently need targeted interventions to improve uptake of cancer screenings in the most deprived areas, alongside access to the latest advances in screening.

"This includes a review of procurement rules to ensure that we have state-of-the-art scanners that can help find cancer earlier.

"There must also be work undertaken with clinicians and charities which sets out a comprehensive vision for cancer care, which includes how we improve screening services and waiting times."

Lung cancer remains Scotland’s biggest cancer killer, claiming 3,651 lives in 2024 - more than one in five cancer deaths.

The divide is stark. In the most deprived communities, the lung cancer mortality rate is around three-and-a-half times higher than in the least deprived areas.

Progress is also slower in poorer areas, with mortality falling by just 7% compared with 18.6% in the wealthiest communities.

The Scottish Liberal Democrats have urged ministers to introduce a nationwide lung cancer screening programme, warning that patients should not have to wait years for measures designed to improve prevention and early diagnosis.

The party said similar programmes were being rolled out elsewhere in the UK, while Scotland had not progressed beyond a pilot scheme.

Scottish Liberal Democrat health spokesperson Adam Harley MSP said: “These figures illustrate the worrying prevalence of cancer deaths across Scotland.

“Survival rates for lung cancer aren’t much better than what they were in the 1970s, and access to diagnosis and treatment can still be a postcode lottery.

“A national lung cancer screening programme, which is already underway in England, could make a big difference, and that’s why my party have been calling for it to be rolled out across Scotland.

“Cancer patients shouldn’t be waiting years for interventions like this. The government should be doing everything they can now to deliver on prevention and early diagnosis because that is how we can save lives.”

The deprivation figures were included in a planned revision of Public Health Scotland’s annual cancer mortality report, published on July 14.

The revision followed the publication of updated small-area population estimates and added analysis based on the Scottish Index of Multiple Deprivation. Public Health Scotland said the results contained in the previous version of the report were otherwise unchanged.

Across Scotland, 16,352 deaths from cancer were registered in 2024, up 2.1% from 16,011 in 2015.

However, after adjusting for changes in the age and sex profile of the population, the overall risk of dying from cancer fell by 12.1% over the same period.

Public Health Scotland said the increase in the number of deaths largely reflected Scotland’s ageing population, with 70% of cancer deaths involving people aged 70 or older.

A Scottish Government spokesperson said:  “The risk of dying from cancer in Scotland is now at the lowest rate on record for men and women, falling by 12.1% over the past decade.  

“This encouraging trend reflects earlier detection, more effective treatments and our continued investment in cancer services. 

"While more people are being diagnosed with cancer due to our ageing population, survival outcomes are improving - with the average age at death from cancer rising steadily since 2000.  

“We are supporting prevention, screening, earlier diagnosis and high quality treatment to help close the deprivation gap. This includes our Detect Cancer Earlier programme to reduce later stage disease, rapid cancer diagnostic services and investment in tackling screening inequalities - to ensure everyone has equitable access to cancer care and support.”