Breast cancer inequality: NI women in lowest-value homes face stark survival gap
(L-R): Breast cancer patient Joanna Bingham pictured with two other breast cancer speakers, Kasia Garble (50) from Belfast and Ann McBrien (63) also from Belfast, alongside Dr Damien Bennett, Director of the Northern Ireland Cancer Registry (NICR) at Queen's University Belfast.
Saturday 10 October 2026
Women living in Northern Ireland's lowest-value homes are almost twice as likely to be diagnosed with Stage 4 breast cancer, with major research also revealing a stark divide in survival rates.
Around one in six women in the lowest-value homes died from breast cancer within five years of diagnosis, compared with fewer than one in ten in the highest-value homes.
The findings are among several studies highlighted by the Northern Ireland Cancer Registry (NICR) during Breast Cancer Awareness Month, as a new £383,600 research project seeks to understand why some patients with advanced breast cancer face greater disadvantages than others.
Stark differences in diagnosis and survival
Researchers examined 12,766 women diagnosed with breast cancer in Northern Ireland between 2011 and 2021, investigating whether the value of their homes was associated with the stage of cancer at diagnosis and their chances of survival.
They found that 7.5% of women living in the lowest-value homes were diagnosed with Stage 4 breast cancer, compared with 4.1% of those in the highest-value homes.
The difference extended to survival, with 16% of women in the lowest-value properties dying from breast cancer within five years, compared with 9% in the highest-value properties.
House value was more strongly associated with breast cancer outcomes than traditional measures of deprivation based on the neighbourhood in which patients lived.
Among women living in the most deprived areas, approximately 15% died from breast cancer within five years, compared with 12% in the least deprived areas.
The findings reveal substantial inequalities but do not establish that property values themselves cause later diagnosis or poorer survival.
Financial pressures and delays seeking medical advice
Further research suggests that financial circumstances and awareness of breast cancer symptoms may also affect patients' experiences.
An online survey of more than 1,000 Northern Ireland residents with breast cancer found that some had delayed seeking medical advice, while others experienced financial difficulties accessing screening, diagnosis or treatment.
Preliminary findings revealed:
• 16% had delayed seeking medical advice about a breast concern.
• 15% reported financial difficulties accessing screening, diagnosis or treatment.
• 9% had been unaware of breast cancer signs and symptoms before diagnosis.
• 17% of respondents educated to secondary-school level reported a lack of symptom awareness, compared with 6% of university-educated respondents.
• 10% of those with household incomes below £31,000 reported a lack of awareness, compared with 5% of those earning more than £52,000.
• 17% of respondents in households earning below £31,000 experienced financial difficulties accessing breast cancer services, compared with 11% of those earning above £52,000.
The findings highlight how income and education are associated with differences in patients' awareness and experiences of accessing care, although the survey does not establish that these factors directly caused delays or poorer outcomes.
Mental health and breast cancer outcomes
A separate study involving 13,846 women investigated whether prescriptions for antidepressants, anti-anxiety medication or antipsychotic medication before a breast cancer diagnosis were associated with the stage of disease or subsequent survival.
Researchers found that women prescribed these medications were not more likely to be diagnosed with Stage 4 breast cancer.
However, women prescribed antipsychotic medication had a 45% higher relative risk of dying from breast cancer, while those prescribed antidepressants had an 11% higher relative risk, compared with women not prescribed the respective medications.
These figures describe relative differences in risk, not increases of 45 or 11 percentage points. The research does not establish that the medications themselves caused poorer survival.
Women prescribed antipsychotics were also more likely to have an unknown cancer stage recorded at diagnosis, suggesting that some patients may benefit from additional support throughout their cancer care.
Reassuring findings for rural patients
Another study, involving 13,629 women, examined whether living further from GP surgeries and cancer treatment centres was associated with later diagnosis or poorer survival.
Despite concerns about access to healthcare in rural communities, researchers found no evidence that longer travel times were associated with more advanced disease at diagnosis or increased breast cancer mortality.
Women living more than an hour from their surgical treatment hospital had similar survival outcomes to those living within 15 minutes, while travel time to chemotherapy services was also unrelated to survival.
The findings offer reassurance for patients in rural communities across County Antrim and wider Northern Ireland, although they do not mean that travelling for appointments presents no financial or practical difficulties.
New £383,600 study into advanced breast cancer
The latest research project, funded by Breast Cancer Now, will examine inequalities affecting people living with metastatic breast cancer, also known as advanced or Stage 4 disease.
Metastatic breast cancer occurs when cancer spreads to other parts of the body, including the bones, lungs, liver or brain. Although treatment can help control the disease, it cannot currently be cured.
Previous research supported by Cancer Focus estimated that approximately 1,000 people were living with metastatic breast cancer in Northern Ireland.
This includes people diagnosed with advanced disease when their cancer is first discovered, as well as those whose breast cancer returns and spreads following earlier treatment.
The new project will investigate inequalities throughout diagnosis, treatment, ongoing care and access to support services, building on earlier work examining patients with primary breast cancer.
Dr Damien Bennett, Director of the Northern Ireland Cancer Registry at Queen's University Belfast, said:
“Our region was among one of the first countries in the world to produce estimates of the numbers of metastatic breast cancer patients, as cancer registries don’t routinely record these data.
“This was thanks to ground-breaking research supported by Cancer Focus which estimates about one thousand people are living with metastatic breast cancer in NI – some of whom are first diagnosed with metastatic disease as their primary cancer, but others who develop recurrent or secondary metastatic breast cancer. With Dr Charlene Mc Shane and staff from the Centre for Public Health at Queen's, we will extend this study of inequalities to secondary/metastatic breast cancer patients."
The work will involve Dr Bennett, Dr Charlene McShane and colleagues at the Centre for Public Health at Queen's University Belfast, with support from Breast Cancer Now.
Patients' experiences at heart of research
The findings were highlighted at a Breast Cancer Information Day held at Queen's University Belfast on Friday 9 October, bringing together patients, clinicians, researchers, funders and medical experts.
Three patients, Ann McBrien BME, Joanna Bingham and Kasia Garbal, were among those scheduled to share their personal experiences of breast cancer, alongside contributions from Siobhan O'Neill, a Specialist Breast Care Nurse with Belfast Health and Social Care Trust.
The event also featured a programme involving Northern Ireland's Chief Medical Officer, Professor Sir Michael McBride, senior public health representatives and cancer specialists.
Organised by the Northern Ireland Cancer Registry, the gathering aimed to strengthen understanding of how breast cancer affects patients and where inequalities in care and outcomes remain.
Breast cancer treatment during the pandemic
Researchers also examined the impact of COVID-19 disruption on breast cancer services and patient survival.
Despite major changes to treatment arrangements, including temporary hormone treatments and shorter radiotherapy schedules, the study found no statistically significant adverse impact on survival among women diagnosed during the pandemic.
The findings demonstrate how services adapted during a major crisis, while emphasising the importance of clear communication and emotional support for patients.
Turning research into better patient support
The Northern Ireland Cancer Registry, based within the Centre for Public Health at Queen's University Belfast and funded by the Public Health Agency, produces official statistics on cancer diagnoses, survival and the number of people living with cancer.
Its findings raise an important question for cancer services across Northern Ireland: why do some patients experience significantly poorer outcomes when distance from healthcare facilities does not appear to explain the difference?
The newly funded research will seek to build on that evidence, identifying inequalities among people with advanced breast cancer and where additional support could make the greatest difference.
For patients and families, the challenge is ensuring that a clearer understanding of these inequalities ultimately leads to more equitable access to information, treatment and care.
