A recent report by One Cancer Voice, a coalition of over 60 cancer charities, has raised alarm bells about the future of cancer care in England. Projections indicate that by 2040, more than 6.3 million new cancer cases could be diagnosed, equating to a New Cancer Case Every Two Minutes. This marks a significant increase from the current rate of one diagnosis every four minutes in the 1970s.
The report highlights that the surge is primarily driven by an ageing population and lifestyle factors, placing unprecedented pressure on the National Health Service (NHS). With the NHS already struggling to meet demand, the coalition is urging the government to implement robust strategies to prevent, diagnose, and treat cancer effectively.
Ageing Population: A Key Driver of Rising Cancer Cases
One of the primary factors contributing to the projected increase in cancer cases is England’s ageing population. As people live longer, the risk of developing cancer rises significantly, with over half of new diagnoses occurring in individuals aged 70 and older. The report notes that the demographic shift towards an older population is a major driver of the expected 14.2% rise in cancer cases, from 5.5 million over the past 15 years to 6.3 million by 2040.
This increase is particularly pronounced in regions with larger and older populations, such as the South East, which is expected to see over one million new cases by 2040, followed by the North West (865,000 cases), the East of England and South West (722,000 cases each), and London (714,000 cases). The link between age and cancer risk is well-established, as cellular damage accumulates over time, increasing the likelihood of malignant transformations. The report underscores that this demographic trend is unavoidable, but its impact on the healthcare system can be mitigated through proactive measures.
For instance, earlier detection and improved screening programs could catch cancers at more treatable stages, reducing the burden on NHS services. However, the current strain on the NHS, exacerbated by an ageing population, has led to delays in lifesaving treatments, with cancer services described as “buckling” under pressure. Without significant investment in infrastructure, staff training, and diagnostic capabilities, the NHS risks being overwhelmed by the sheer volume of cases in the coming decades.
Read : Large Number of Lung Cancer Patients in India Never Smoked: Lancet Study
Lifestyle factors also intersect with age, as older individuals may have been exposed to risk factors such as smoking or poor diet over longer periods. The report emphasizes that while ageing is a natural process, the compounding effect of lifestyle choices amplifies the cancer burden. Addressing these modifiable risk factors is critical to reducing the projected surge in diagnoses and ensuring that the NHS can cope with the growing demand for cancer care.
Lifestyle Factors Fueling the Cancer Surge
In addition to an ageing population, lifestyle factors are significantly contributing to the projected rise in cancer cases. The One Cancer Voice report highlights that preventable causes, such as smoking, obesity, alcohol consumption, and physical inactivity, are driving increases in specific cancers, including lung, breast, prostate, and colorectal cancers.
Approximately four in 10 cancer cases are preventable, with smoking and obesity being the two leading causes. By 2040, smoking alone is expected to contribute to around one million cancer cases in the UK, while obesity is projected to become an even more significant risk factor as more people are classified as obese than at a healthy weight.
Specific cancers linked to lifestyle factors are expected to reach record highs. For instance, prostate cancer diagnoses are projected to exceed one million by 2040, with breast cancer cases reaching 906,000 and lung cancer cases hitting 821,000. Other cancers, such as liver, kidney, and oral cancers, are also on the rise due to alcohol consumption, obesity, and UV exposure.
The report notes a concerning 61% increase in kidney cancer cases by 2040, from 13,600 annually in 2019 to approximately 21,900. Similarly, liver cancer deaths are expected to rise from 6,000 to 9,500 per year, driven largely by alcohol and obesity-related risk factors. The rise in early-onset cancers among those under 50 is particularly alarming, with a 24% increase in incidence since 1995. Experts attribute this trend to soaring obesity levels, poor diets, and sedentary lifestyles. For example, bowel cancer cases in younger populations are linked to dietary habits and gut microbiome changes, which can accelerate cellular ageing in the colon.
These findings underscore the need for robust public health campaigns to promote healthier lifestyles, including smoking cessation programs, policies to combat obesity, and initiatives to reduce alcohol consumption. The report also highlights the success of past prevention efforts, such as cervical cancer screening and HPV vaccination, which have reduced mortality rates by over 54% in some cases, demonstrating the potential impact of targeted interventions.
One Cancer Voice’s Call to Action: A National Cancer Plan
To address the projected surge in cancer cases, One Cancer Voice is advocating for a comprehensive national cancer plan to transform England’s approach to cancer care. The coalition has outlined six critical “tests” that the government must meet to ensure the NHS can handle the rising demand and improve outcomes for patients. These include meeting all cancer waiting time targets by the end of parliament in 2029, setting new and earlier diagnosis goals, improving screening programs, implementing strong cancer prevention policies, addressing inequalities in patient care, and enhancing support for those living with and beyond cancer.
The Department of Health and Social Care launched a call for evidence in February 2025 to shape this national cancer plan, with a blueprint expected later this year. Michelle Mitchell, chief executive of Cancer Research UK and a representative of One Cancer Voice, described the plan as a “defining moment” that could propel England from lagging behind comparable countries to becoming a world leader in cancer outcomes.
The coalition emphasizes the need for earlier diagnosis, as patients in poorer areas are currently more likely to be diagnosed late, facing greater barriers to accessing optimal treatment. This disparity is particularly stark in regions like the North East, which is expected to see a smaller increase in diagnoses (340,000 cases by 2040) but still faces significant challenges due to socioeconomic factors.
Prevention is another cornerstone of the coalition’s recommendations. By taking bold action against smoking, obesity, and alcohol, nearly 37,000 cancer cases could be prevented by 2040. Initiatives such as optimized bowel cancer screening and targeted lung cancer screening, currently being rolled out across England, are critical to reducing inequalities and saving lives.
The report also calls for improved access to clinical trials and better emotional and practical support for cancer patients, including embedding psychological care within NHS services. Professor Sir Mike Richards, former national cancer director, highlighted the success of previous NHS cancer plans in improving outcomes and expressed optimism that a new, fully funded strategy could position England among the best in the world for cancer survival.
The urgency of these recommendations is underscored by the current state of NHS cancer services, which are struggling to meet waiting time targets and cope with chronic staff and equipment shortages. The pandemic has further exacerbated these challenges, disrupting cancer care and contributing to backlogs.
Without swift action, the projected 6.3 million new cases by 2040 could push the system beyond its breaking point, leading to more delayed diagnoses and preventable deaths. One Cancer Voice’s call for a fully funded, ambitious strategy is a rallying cry for policymakers to prioritize cancer care and invest in the resources needed to meet this growing challenge.
In conclusion, the One Cancer Voice report paints a sobering picture of England’s cancer landscape by 2040, with a new diagnosis expected every two minutes. The ageing population and lifestyle factors such as smoking, obesity, and alcohol consumption are driving this surge, particularly in high-risk regions like the South East.
However, the coalition’s proposed national cancer plan offers a roadmap to mitigate this crisis through earlier diagnosis, robust prevention policies, and equitable access to care. By addressing these challenges head-on, England has the opportunity to transform its cancer outcomes and ensure that the NHS is equipped to handle the rising tide of diagnoses. The time to act is now, as the next 15 years will determine whether England can become a global leader in the fight against cancer.