Do wait times for breast cancer surgery in the UK vary by socioeconomic status?

One of the key benefits of the UK health system is that everyone has access to care. However, is care provided equally to all people?

A paper by Matias et al. (2024) examines whether or not there are any inequalities in waiting times by socioeconomic status for women diagnosed with breast cancer in England and who require either a mastectomy or breast conserving surgery.  The authors use data from Hospital Episode Statistics (HES) between 2015 and 2022 to measure wait time between a specialist’s diagnosis and time to surgery. Inequalities are measured based on income deprivation by geographic area [specifically, the Lower Super Output Area (LSOA)]. The analysis controls for a variety of patient characteristics as well as hospital fixed effects.

Using this approach, they find that:

In the pre-COVID-19 period, we do not find statistically significant associations between income deprivation in the patient’s area of residence and waiting times for surgery. In the COVID-19 period, we find that patients living in the most deprived areas have longer waiting times by 0.7 days (given a mean waiting time of 20.6 days).

While we do see inequalities appear in the post-COVID period, the difference is fairly modest (about 1 day). Further, other studies (e.g., Saito et al. 2021) found little difference in cancer surgery wait times by socio-economic status (although this was pre-COVID levels). In short, NHS still appears to be highly egalitarian, but there are the beginnings of some worrying trends.