Overcoming health inequalities for early cancer diagnosis.

Sep 9, 2020 | Cancer Diagnosis, Covid-19, Social Problems

People in the most socio-economically deprived areas in England are 20% more likely to have their cancer diagnosed at late stage than people in the in the least deprived areas. Why is this and how can we prevent this in the future?

Health inequalities re-emphasised by Covid-19 pandemic

Amidst the Covid-19 emergency the flaws in our healthcare systems are becoming ever more evident and exposed. Recent statistics reveal the healthcare inequalities experienced by low-income workers and people living in overcrowded housing with a healthy life expectancy between the least and the most deprived areas in England being 19 years.

Multiple factors

The disadvantages faced by people in the most socio-economically deprived areas are multifactorial.

Rural and deprived areas that receive less funding often lack adequate healthcare infrastructure. Consequently, people from these areas must rely on transport to reach a healthcare professional, which is often costly, time-consuming and difficult.

As a result, this discourages groups from these areas seeking a timely diagnosis and medical care. This leads, in the longer term, to more complex medical treatments and poorer outcomes.

Language and understanding barriers can also be a cause contributing to health inequality. 23% of patients in deprived areas have claimed that cancer test results were explained to them inadequately (compared to 19% in less deprived areas). The confusion and uncertainty these people are left with is emotionally unsettling, but also paves the way to a lack of awareness regarding symptoms or side effects. Language barriers leave cancer patients feeling out of control in relation to their treatment. Perhaps this is why only half the number of referrals to early-phase cancer clinical trials are attributed to socio-economically deprived individuals.

Patient history is crucial for early cancer diagnosis, especially given that individuals from more socio-economically deprived areas are more likely to be smokers, which is a salient factor when recommending preventative cancer screenings to patients (3).

Re-modelling cancer services to eliminate health inequality

Breaking down deep-rooted health inequality barriers requires a re-formulation of our healthcare system. The goal must be early cancer diagnosis for all, irrespective of socio-economic status, geography, social, educational and biological factors. This has been recognised within the NHS Long Term Plan’s Milestones for Cancer which includes a goal to diagnose 78% of cancers at early stage one or two by 2028.

Emerging from a partnership of NHS England, Cancer Research UK, Macmillan Cancer Support is a service model for cancer diagnosis – Rapid Diagnostic Centres (RDCs) whose vision is to deliver faster and earlier diagnosis and improved patient experience for all.

Making the best use of technology

RDCs advocate the use of technology in the form of artificial intelligence (AI) and more widely it is recognised that ‘Big-Data’ driven diagnosis solutions can revolutionise the diagnosis of cancer and reduce health inequalities. Examples where AI can support the cancer diagnosis pathway by drawing upon a global database of the most up-to-date evidence- based cancer data include:

· Pre-consultation patient engagement and history taking

· Analysis of an individual’s cancer risk factors

· Predictive diagnosis and triage

· Clinician decision support

· Patient education and support

Find out more about how YouDiagnose uses AI to eliminate health inequalities in cancer diagnosis << Link to website/crowdfund page>> https://youdiagnose.online/


Miss. Olivia Whimpenny, Dr Aswini Misro