Report finds nearly 1.4 million UK cancer patients affected by a 'postcode lottery' of care

Almost 1.4 million people living with cancer in the United Kingdom have been disadvantaged by a "postcode lottery" of care, a report from Macmillan Cancer Support found, with four in 10 patients saying they struggled to access the most suitable treatment because of where they live.

The charity said the variation in care means some patients have fewer treatment options and are forced to travel long distances for tests, scans and therapy, adding financial and emotional burdens. Macmillan's analysis of patient responses and NHS data found 36 percent of people with cancer had travelled more than an hour for a test, scan or treatment, and about 3 percent — roughly 100,000 patients — had turned down an appointment because it was too far away, a decision the report said put lives at risk. The report also estimated that around 60,000 more people each year would receive faster cancer care if waiting times across the UK matched those in the best performing areas.

Macmillan said the differences were not limited to older, well‑established treatments but extended to newer, innovative therapies, including personalised medicines that depend on timely biomarker testing. The charity likened the situation to "flipping a coin" to determine the care available to an individual, saying geographic variation left some patients with little choice but to travel or to accept treatment that may not be best suited to their condition.

The report documented patient experiences of increased costs, stress, anxiety and exhaustion associated with long journeys for care, and highlighted that distance and lack of local services could lead to missed or declined appointments. Macmillan said the findings reflected inconsistencies in waiting times and the availability of treatments across different regions and trusts.

Macmillan called for action to reduce unfair variation so that access to tests, scans and treatments does not depend on postcode. The charity said aligning national waiting times with the best performing areas and ensuring consistent provision of biomarker testing and personalised therapies would help more people get faster, appropriate care.

The report is based on the charity's review of patient-reported experiences alongside NHS performance data. It offers a regional comparison of waiting times and service availability that Macmillan says demonstrates clear disparities in how quickly and comprehensively cancer care is delivered across the UK.

Health policy experts and patient groups have for years warned about regional disparities in NHS services. Macmillan's analysis provides updated figures it says quantify both the personal cost to patients and the potential system‑level benefit of reducing variation: faster treatment for tens of thousands of people annually if the slowest areas could reach the performance of the fastest.

The charity urged policymakers, NHS leaders and commissioners to prioritise measures that ensure equitable access to diagnostic tests and modern treatments, including investment in biomarker testing capacity and pathways that reduce travel burdens for patients. Macmillan said addressing the postcode lottery is necessary to prevent avoidable suffering and to improve outcomes for people living with cancer across the country.