Multimorbidity in patients living with and beyond cancer by cancer site, ethnicity and socioeconomic status

Around 2.5 million people in the UK are living with and beyond cancer (“cancer survivors”), with many expected to live 10 years or more. Most cancer survivors experience multiple long-term health conditions (multimorbidity), which can affect their cancer outcomes and overall health. Previous research showed that 40-69% of cancer patients have at least one other condition, and 12-32% have more than one.

This project used large UK primary care and hospital data to explore patterns of multimorbidity, healthcare use, and outcomes among cancer survivors compared to matched non-cancer patients, focusing on differences by ethnicity and socioeconomic status (SES).

Findings from this study will demonstrate the variability of multimorbidity associated with 28 cancer types and how this is influenced by ethnicity and socio-economic conditions. Findings could be incorporated into UK Cancer Care Reviews and influence policies to develop integrated management of multimorbidity tailored to specific cancers, which will promote equitable, better integrated care for cancer survivors.

Cancer survivors had a significantly higher prevalence of multimorbidity (almost six times greater odds) and were more likely to have 22 out of 29 long-term conditions five years after diagnosis.

Non-White ethnic groups, especially Black African and Bangladeshi survivors, were diagnosed with cancer at a younger age.

Black survivors had the highest risk of death from all causes.

Asian survivors had the highest rates of multiple conditions and the greatest use of primary care and hospital services, particularly among Pakistani survivors.

Some Black ethnic groups showed lower recorded multimorbidity and fewer primary care visits despite higher mortality, suggesting possible underdiagnosis or barriers to care.

Lower socioeconomic status was consistently linked to more multimorbidity, higher mortality, and greater healthcare use.

These findings highlight the urgent need for early, targeted interventions that consider ethnicity and socioeconomic factors to improve care and outcomes for cancer survivors. They also reveal potential inequalities in access to primary care among certain ethnic groups, which could contribute to worse health outcomes.

Institute of Population Health Sciences, QMUL

Cancer Research UK Barts Centre

East London Genes and Health