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Revealed: Britain's north-south cancer divide

Health Editor,Jeremy Laurance
Wednesday 06 July 2005 00:00 BST
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Cancer strikes more than twice as often in some parts of the country than others. The Cancer Atlas of the UK and Ireland 1991-2000 shows that some cancers such as those of the lung, show a strong north-south divide but others, such as those of the brain and kidney, fall equally across the country.

The atlas is the first of its type to be published by the Office for National Statistics and provides insights into the causes of cancer and the effectiveness of the NHS in treating it.

One of the most striking maps is for melanoma, the most lethal form of skin cancer, which shows the highest rates in Devon and Cornwall and along the south coast. These are also the sunniest counties of England and sunburn is known to cause of melanoma.

Melanoma is also high among the Celtic populations of Scotland and Ireland where, despite the lack of sun, the prevalence of pale skin, red hair and freckles renders the population more vulnerable, especially among those who holiday in sunnier countries abroad.

The atlas shows lung cancer rates are up to 50 per cent higher than average in a band across the north of England, through Merseyside, Manchester and Newcastle and across central Scotland. In the south, lung cancer rates are almost a third lower than average.

The pattern of the disease mirrors that for deprivation which is linked with high rates of smoking. Other cancers caused by smoking - those of the larynx, lip, mouth and pharynx - show the same geographical pattern.

Breast cancer, the commonest in women, has slightly higher rates in a band from Hertfordshire to Dorset, in north Wales and the north of Scotland.

Breast cancer is a disease of affluence which is still marginally more common in the better-off south of the country. It is thought to be because more affluent career women tend to start their families later, sacrificing the protective effect of an early pregnancy against the disease.

Prostate cancer, the fastest rising cancer in men, shows little geographical variation in incidence

But cervical cancer, by contrast, is a disease of deprivation with the highest rates in a band across the country from Merseyside to Hull. The cancer is strongly associated with human papilloma virus , the cause of genital warts, which is believed to be more prevalent in the north-west.

Bowel cancer also shows a north-south divide, with highest rates in Scotland and Ireland and the lowest in London and the south. But there was an even bigger difference in death rates, suggesting that NHS treatment in the north is inferior, or delivered later in the course of the illness, than in the south.

Mike Quinn, chief author of the atlas, said: "It is important to remember that places do not get cancer, people do. If you live in an area with a high rate of lung cancer but do not smoke you would be unlucky to get the disease."

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: "These statistics highlight the number of cancer cases and deaths that are preventable. They estimate that if every part of the UK had the same incidence and mortality rates as the healthiest areas, 25,580 cases and 17,450 deaths could be avoided."

"In fact, we know that half of all cancers - equivalent to around 135,000 cases a year in the UK - could be prevented by changes to lifestyle."

Professor Jessica Corner, director of improving cancer services at the charity Macmillan Cancer Relief, said: "Cancer services have benefited from unprecedented levels of government spending since the NHS cancer plan was published in 2000. However, the persistence of regional variations in the cases of cancer occurring and those dying from it show that the battle is far from won."

She added: "Cancer must remain a disease priority for the Government. There are still instances of unacceptable delays in diagnosis and treatment and it is important the Government works to reduce these further."

n The north-south divide in heart disease deaths shows no signs of narrowing, figures from the British Heart Foundation show today. Deaths rates in Scotland are 67 per cent higher among men and 84 per cent higher among women than in south-west England in under 75-year-olds.

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