Cancer Data Driven Detection: Exploring cancer inequalities in Wales

Only 55% of cancers are currently detected early, highlighting the need for improved prevention, early detection and diagnosis. Increasing availability of diverse, individual-level linked data from population-scale electronic health records, administrative data sources and large-scale cohort studies, along with advances in statistical and machine-learning approaches, offer new opportunities to identify novel cancer risk factors and improve cancer risk assessment. 

Cancer Research UK is leading a new, UK-wide initiative to leverage these advances. Cancer Data Driven Detection aims to deepen our understanding of who is most at risk of developing cancer and hence improve prevention, early detection and diagnosis. 

ADR UK is providing in-kind support to Cancer Data Driven Detection by funding a project using linked administrative and health data to understand the incidence of breast and bowel cancer in Wales. By integrating several sources of data, the project will identify patterns and inequalities in cancer occurrence and screening. These findings will support researchers, policymakers, and health professionals in addressing disparities in cancer diagnosis, care, and outcomes. 

The project 

Breast and bowel cancers are the most common cancers in the UK, with approximately 54,000 and 43,000 new cases diagnosed each year, respectively. Despite the availability of population-based screening programmes, these cancers are associated with significant mortality. 

Considerable advances have been made in genetics and understanding reproductive, hormonal, and lifestyle risk factors. Cancer research also recognises the influence of demographic, socioeconomic, residential, and occupational factors on general health outcomes through deprivation, health behaviours, and access to resources. However, the relationship between these factors and cancer risk specifically remains underexplored. 

This pilot project will use linked administrative and health data from Wales to evaluate how these factors influence breast and bowel cancer incidence. This can shed light on pathways to diagnosis, identify at-risk populations, and inform policies to minimise health inequalities. Following this initial pilot, a further project will then build on the pilot outcomes and align to the wider Cancer Data Driven Detection programme. Details of the project will be updated here. 

The data 

The pilot project will combine cancer and health services data with administrative data available in the Secure Anonymised Information Linkage (SAIL) Databank. By linking de-identified, population-scale, individual-level data from Wales, which includes demographic, socioeconomic, occupational, residential, and clinical characteristics, the project will examine the services and outcomes experienced by different groups.  

This will involve secure access to Census 2021 data from the Office for National Statistics (ONS) within the approved SAIL project (1711) within the SAIL Databank and data from the NHS via Digital Health and Care Wales (DHCW) and Public Health Wales. 

The data sources used in the project include: 

• Care home data 

• Breast Test Wales 

• Bowel Screening Wales 

• ONS 2021 Census Wales 

• Annual District Death Extract 

• Outpatient Database for Wales 

• Emergency Department Dataset 

• Patient Episode Database for Wales 

• Welsh Demographic Service Dataset 

• Welsh Longitudinal General Practice data 

• Cancer Network Information System Cymru 

• Welsh Cancer Intelligence and Surveillance Unit. 

Potential of the research 

The objective of the pilot project is to provide a descriptive analysis of the distribution of relevant characteristics among individuals diagnosed with invasive breast or bowel cancer in Wales and compare these distributions with those of the general population. Examining these groups separately will uncover patterns in cancer incidence, screening participation, and healthcare access. The findings and insight will also inform the broader Cancer Data Driven Detection programme and help shape the direction of the UK-wide initiative. 

This pilot will address the following questions: 

1. How do demographic factors (age, sex, ethnic group) influence the incidence of breast and bowel cancers in Wales? 
2. Are there geographical or residential disparities in the diagnosis of breast and bowel cancers? 
3. What is the relationship between sex, socioeconomic status, education level, and occupation in relation to cancer screening participation? 

The findings will inform targeted interventions along with strategic discussion across the UK network and policy development, with the potential to reduce health inequalities. The project’s approach can serve as a foundation for future studies that use linked health and administrative data within the SAIL Databank, as well as other trusted research environments and secure data environments across the UK and worldwide. As part of the UK-wide CD3 programme, this research ultimately aims to advance cancer prevention and early detection and diagnosis, with a strong focus on health equity. 

Project details 

Project lead: Antonis Antoniou 

Funded value 

Pilot: £25,000 

Project: Up to £100,000 (project scope to be determined by pilot) 

Project duration 

Pilot: Aug 2024 – Mar 2025 

Project: April 2025 – March 2026 

This work is funded by ADR UK as part of a strategic partnership and collaboration with the Cancer Research UK Cancer Data Driven Detection programme. The work is supported by ADR Wales.