Head and neck cancer hits the North of England and Scotland hardest
People in the most socioeconomically deprived areas of the UK are more likely to die from head and neck cancer, more likely to be diagnosed at advanced stages, and more likely to wait longer for treatment than those in the most affluent areas, according to new analysis.
A report from the Northern Head and Neck Alliance (NHNA) and Health Equity North highlights the stark socioeconomic inequalities in head and neck cancer across the UK, with those from the poorest areas disproportionately affected.
These inequalities are apparent across the entire head and neck cancer pathway – from disease risk to stage of diagnosis, to access and adherence to treatment, and to quality of life and survival outcomes.
‘Hard to Swallow: The Truth about Head and Neck Cancer Inequalities’ shows that parts of northern England and Scotland have some of the highest rates of the disease, both in terms of new cases and deaths, with numbers predicted to rise in coming years.
The research team included experts from Newcastle University, University of Glasgow, University of Sheffield, and University of Liverpool along with clinical colleagues from the NHS in the North of England and Scotland. They analysed existing data to outline the latest evidence on socioeconomic inequalities in head and neck cancer and their unequal impact on the North of England and Scotland.
They found:
- Patients in the most socioeconomically deprived areas are nearly 2.5 times more likely to die from head and neck cancers than those in the least socioeconomically deprived areas.
- All seven northern Integrated Care Boards have higher rates of head and neck cancer than the England average. Six also have higher death rates, with the North East and North Cumbria the worst in the country. Scotland’s rates are even higher again.
- Those from the poorest areas in England are 16% more likely to be diagnosed with advanced disease than patients from the most affluent areas.
- Head and neck cancer patients in England have some of the poorest waiting times for treatment and almost 50% do not start within the NHS 62-day target.
- Patients from the most socioeconomically deprived areas are 33% more likely to wait over 104 days.
The analysis also explored HPV vaccination rates and dental referral, which both show how disadvantage shapes people’s chances of preventing or spotting head and neck cancer early. It found that uptake of the HPV vaccine – one of the key tools for preventing some types of head and neck cancer – is 21% lower in the most socioeconomically deprived areas. At the same time, people in the poorest areas are less likely to be referred by a dentist when early symptoms appear, despite dental referral playing an important role in early detection.
Head and neck cancer is a collective term for cancers of the mouth, tongue, saliva glands, nose, throat, and voice box. The disease and its treatment can lead to life changing effects on swallowing, speech, relationship intimacy, appearance, taste appreciation, and enjoyment of food.
Currently, head and neck cancer affects nearly 13,000 new people per year in the UK, and the disease is responsible for 5,000 deaths each year. The numbers are rising and are expected to continue to increase with annual numbers predicted to reach over 16,000 new cases in the 2030s.
Following the publication of today’s new analysis, the researchers behind the findings are urging stronger action to tackle the inequalities affecting this often-overlooked cancer.
The NHNA is an extensive network of academic and clinical experts in head and neck cancer – convened by the Northern Health Science Alliance – from universities and NHS trusts across the North of England and Scotland.
The NHNA’s recommendations in the report call for targeted action across public health, NHS services, and research. Key priorities include expanding stop‑smoking and alcohol‑reduction support in the communities that need it most, strengthening tobacco control, and increasing HPV vaccination uptake in disadvantaged schools.
They also urge fairer access to NHS care, with improved primary care and dentistry provision, closer monitoring of waiting‑time inequalities, and services designed in partnership with local communities. The report authors say increased research investment is needed to understand the drivers of inequality, develop new prevention and early‑detection approaches, build a national head and neck cancer cohort, and widen clinical trial participation among underserved groups.
Professor Matt Ashton, Director of Public Health for Liverpool City Council, who wrote the Foreword in the report, said: “Head and neck cancer remains one of the most under‑recognised and unfairly distributed cancer burdens in our communities. People in our most disadvantaged areas are facing higher risks, later diagnoses, and tougher treatment journeys than anyone should have to endure. This report lays out those inequalities with real clarity and brings forward practical opportunities to change that story across prevention, diagnosis, treatment, and survivorship.”
Mr James O’Hara, Clinical Senior Lecturer at Newcastle University, Consultant ENT surgeon at The Newcastle upon Tyne Hospitals NHS Foundation Trust and Deputy Chair of the Northern Head and Neck Alliance, said: “No cancer should be more deadly because of the community you come from. Head and neck cancer may be a relatively rare cancer, but the inequalities surrounding it are not. When poorer communities face higher risks and worse outcomes, we are failing them. Fixing that failure would improve care for every patient.
“The Government’s National Cancer Plan recognises the importance of prevention, early diagnosis, and tackling the risk factors that cluster in poorer areas, and many of its commitments align closely with the actions we urgently need. By strengthening tobacco and alcohol control, boosting HPV vaccination, improving access to timely care, and investing in research and innovation, we can start to close these gaps and transform outcomes for future generations.”
Professor David Conway, Professor of Dental Public Health at the University of Glasgow and Honorary Consultant in Dental Public Health with Public Health Scotland said: “Societal inequalities in income, wealth, and power drag our nations’ health. Head and neck cancer – mainly tumours of the mouth, throat and voice box – are such life changing diseases impacting those from the poorest and most disadvantaged communities most. The recommendations in this report recognise the need for reducing the root causes of poverty and inequality but also set out a clear path to tackling the ingrained inequalities in head and neck cancer risk, diagnosis, treatment and survival rates. Strengthening prevention, improving access to primary care and dentistry, and investing in early detection are all within our reach. By acting on these recommendations, we can ensure that people in our most disadvantaged communities are no longer left behind. Addressing the challenge of inequalities in head and neck cancer would create a template for tackling cancer and wider health inequalities.”
Hannah Davies, Executive Director at Health Equity North, said: “Head and neck cancer is a cruel disease that can have life threatening and life changing effects on patients. This reality is often felt more acutely in deprived communities in the North, as shown in our new analysis. Where you live, how much money you have, and the challenges you face in daily life shouldn’t dictate your chances of surviving this cancer.
“As the number of new cases of head and neck cancer continues to steadily rise, we need to see clear, decisive action to prevent head and neck cancer and address the long-standing inequalities that leave people in deprived communities facing worse outcomes.”