Exploring cancer inequalities in Wales through linked administrative data

This Data Insight describes the study which assessed the feasibility of linking administrative data from different sources. It used cancer service data, including screening and diagnosis records, with additional administrative data within the SAIL Databank, with a particular focus on the 2021 Census.

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Background

Breast and bowel cancers are the most common and fourth most common cancers in the UK. Despite significant advances in understanding the genetic, reproductive, hormonal, and lifestyle risk factors associated with these cancers, the impact of demographic, socioeconomic, residential, and occupational factors in the UK remains largely unexplored.

Understanding how these factors are associated with breast and bowel cancer incidence can shed light on disease mechanisms, help identify at risk populations, and provide valuable insights for policy interventions.

The 2021 Census data provides essential sociodemographic information to explore patterns in cancer incidence and screening participation in Wales.

Key findings

• Deprivation: Individuals from more deprived areas (WIMD 1-2) were less likely to attend screenings.
• Age: Younger individuals (under 54 for breast cancer, under 59 for bowel cancer) were less likely to participate.
• Employment & education: Employed individuals and those with higher educational attainment were more likely to participate, particularly those with Level 4 qualifications.
• Country of birth & length of residence: People born in the UK or with longer UK residency were more likely to screen.
• Ethnicity: White individuals had higher participation rates than individuals from other ethnic backgrounds, especially Asian groups.
• Language proficiency: English speakers were more likely to attend screenings.
• Marital status & household composition: Married individuals or those in multi-person households were more likely to participate than single or solo-living individuals.
• Health & disability: Individuals reporting poor health or with mobility disabilities had lower screening participation.
• Sex: Women had higher screening rates for bowel cancer.

Why it matters

This study highlights the potential of linking cancer data with administrative data to provide insights into breast and bowel cancers. 2021 Census data was successfully linked to health data within the SAIL Databank to build study cohorts and explore cancer disparities.

The findings reveal that sociodemographic factors influence cancer screening participation, with single individuals, those with lower education, and those from more deprived areas being less likely to engage in screenings.

These insights can inform targeted interventions to improve screening uptake and, consequently, cancer prevention and early detection. This research underscores the value of linked data in identifying health disparities and can guide future strategies to address these inequities