Associate feature: Inequalities in the breast cancer pathway in Scotland: a call to action

Breast cancer is a devastating disease: there are 4,500 breast cancer diagnoses in Scotland every year, which equates to a third of all cancer diagnosis in women in Scotland.¹ However, certain groups of women in Scotland experience significant disparities in access to breast cancer care. A recently published white paper from Pfizer UK Ltd on “Inequalities in Breast Cancer Care” sheds light on the extent of these disparities. The document highlights that individuals living in the most deprived communities in Scotland have lower uptake of breast cancer screening, are more likely to be diagnosed with advanced-stage disease and have poorer survival outcomes.² Although no treatment data are published by deprivation level in Scotland, the 62-day standard time to treat 95% of eligible patients from first referral was only met by three health boards in 2022, with rural health boards meeting the target less than urban ones.³

There is no singular solution to address health inequalities, but the lack of granular data stratified by multiple domains of inequality (e.g. geography, deprivation, ethnicity, age, co-morbidities etc) hampers a comprehensive understanding of the causes and extent of inequalities. The report calls for the publication of more detailed data already collected by Public Health Scotland, including breakdowns by deprivation and geography. Data on ethnicity is lacking throughout Scottish data sets, as are additional measures such as co-morbidities. There is also a lack of focus on groups who may suffer worse outcomes (e.g. homeless people and patients in the justice system). Data for these populations should be collected and considered to ensure robust and holistic inequalities programmes are in place. Such data would enable policymakers and health boards to identify specific populations that are struggling to access care and implement targeted interventions for earlier diagnosis and faster treatment.

At Pfizer, we believe that better health is possible for everyone, everywhere. We all have important roles to play and by working together, we can identify barriers, implement solutions and improve data collection, thereby closing the health equity gap and ensuring access to the breast cancer pathway and treatments for everyone. Patient groups can help provide deeper understanding of barriers for earlier diagnosis and attending screening, provide insights as to what might help improve patients’ quality of life and help implement any solutions. Health boards can lead locally on specific areas in the breast cancer pathway, tackling inequalities as a priority with dedicated leadership to drive local outcomes. Policy makers can endeavour to implement a focused overarching health inequalities strategy, which needs to go beyond deprived communities and include data collection and reach to deprived communities and marginalised groups if actionable. By investing in technical capacity, the NHS can publish data that allow for a thorough understanding of inequalities while maintaining privacy and confidentiality.

The ‘Inequalities in Breast Cancer Care’ white paper serves as a wake-up call to address the disparities that exist in breast cancer outcomes and highlights the urgent need for a coordinated approach to ensure no one is left behind in the fight against breast cancer, whatever their circumstances. Pfizer would like to work alongside the NHS Scotland, local health boards, policy makers, patients and advocates to apply our expertise and resources to bridge gaps and collaborate with local areas in tackling breast cancer health inequalities, whilst ensuring patients receive optimal benefit from innovative medicines, closing the health equity gap and creating lasting social and individual impact.

1. www.cancerreferral.scot.nhs.uk/breast-cancer/?alttemplate=Guideline
2. www.pfizer.co.uk/files/Pfizer-White-Paper-SCOTLAND-2024.pdf
3. Pfizer Data on File: Waiting times by health board

PP-UNP-GBR-10269 September 2024

This article is sponsored by Pfizer.

www.pfizer.co.uk