Get under the skin of how lifestyle and demographic trends can impact cancer care and what this means for improving treatments, the pressures our NHS faces and ultimately quality of life
Lifestyle and demographic changes give the strongest predictors for developing cancer. The risk of developing cancer goes up with age due to biological changes in your body and the chance of being exposed to risk factors. Aspects like obesity and smoking are linked to multiple types of cancer, and social determinants such as socioeconomic status influence cancer incidence by impacting exposure to risk factors and the likelihood of early detection.
Changes to all of the above will shape the future of cancer care. We have an ageing population to consider and lifestyle-related risk factors will continue evolving. Monitoring and understanding these trends can provide a strong foundation for predicting the future needs of cancer care in Wales.
As part of a series of reports looking into the future of cancer care in Wales, I’ve worked as part of the Sector Intelligence team as Life Sciences Hub Wales to examine key trends in lifestyle and demographics. This report provides a look into how these trends could influence cancer incidence, treatment demand and resource allocation.
I’ve put some of the key take-home statistics and thoughts into a blog to summarise. Read on to learn more.
What ageing means for cancer care in Wales
Here in Wales, we’re facing an ageing population. The overall population aged 65 and over in Wales is expected to grow by 19% from 706,000 in 2025 to 841,000 in 2035, which far exceeds other changes in other age groups. This will particularly be the case in more rural areas such as Monmouthshire and Powys.
This ageing population will lead to a rise in overall cancer cases. The result of this is a growing demand for cancer services, whether that’s diagnostic tests, treatments or follow-up care. Investment in infrastructure, new facilities and expanding the workforce is essential for tackling this. What’s more, Welsh Government have highlighted the importance of integrated care , as older adults with cancer often have co-morbidities that need support spanning primary care, specialist services and social care. Integrated care can help to join this up and support patients and reduce the pressure on systems.
What social deprivation means for cancer care in Wales
The report found that local authorities in Wales have varying levels of social deprivation, which looks at factors like employment, education, health and disability, and housing. There’s varying levels of deprivation in Wales – with various statistics pulling up Blaenau Gwent as the highest and Monmouthshire as the lowest.
A few future trends can be pulled out on social deprivation, which includes continued reduction in deprivation levels and continued regional disparities. With regards to the impact on cancer care in Wales, social deprivation is linked to delays in early cancer diagnosis and lower participation in screening programmes.
If unaddressed, challenges posed by social deprivation can worsen cancer care disparities. This can lead to higher incidence, late-stage diagnosis and poorer survival rates. Targeted strategies that reflect regional disparities should be considered to mitigate these effects. Moreover, policy that addresses the underlying causes of deprivation, such as economic inequalities, health disparities and infrastructure challenges should play a vital role.
What smoking prevalence means for cancer care in Wales
We’ve seen smoking rates massively drop in Wales, dipping from 22.3% in 2011 to 12.6% in 2023. And this is predicted to continue as societal attitudes change, and awareness of health risks grow.
This decline will have a big influence on decreasing the incidence rates of cancers such as lung, throat and mouth, causing a shift in demand on cancer care services. Especially as tobacco smoking is the leading cause of cancer in the UK, attributable to 15% of all cancer cases. However, for some time they’ll be a persistence in smoking-related cancers in the short to medium term, particularly among older adults who have smoked for much of their lives.
We also don’t fully know the long-term impact of e-cigarettes and vaping on cancer risk and other public health concerns.
What obesity means for cancer care in Wales
Obesity is one of the biggest public health challenges in Wales. Research has linked it to at least 13 different types of cancer including breast, colorectal, endometrial, ovarian, kidney, liver, gallbladder, and pancreatic. We’re seeing obesity rates rising in Wales - up from 17.8% in 2023/4 to 26% in 2022/3 – and it's predicted to keep going up.
There’s also differing obesity rates depending on where you live in Wales, which again highlights the influence of local socioeconomic factors; areas with the highest obesity rates such as Blaenau Gwent are also among the most deprived. When it comes to care, these regional disparities mean that some areas could face a disproportionate share of people accessing cancer services.
It's not only risk of cancer we need to think about; its treatment is important too. Care can be more complex, require more resource, specialised equipment and training. Public Health Wales put the cost of obesity on NHS Wales at £73 million in 2011, with it predicted to rise to £465 million in 2050. Cancer care, which is a massive part of healthcare expenditure, will feature as a large proportion of these rocketing costs.
Public health interventions are needed to prevent cancer through tackling obesity. Whether that’s community-based programmes, health education or wider policy. A key example of this is Welsh Government’s ‘Healthy Weight: Healthy Wales’.
The clear causal link between these demographic and lifestyle factors and cancer is not only a challenge but presents a real opportunity to intervention to help lower cancer incidence and mortality. This can help us to diagnose and treat cancer more quickly and effectively.
For a deeper dive on the trends and analysis of data, read the report’s executive summary.
