Read Again: Rethinking Cancer Care Through an Equity Lens

Cancer care is never experienced in isolation, and understanding the structural forces that shape health outcomes is essential to delivering more equitable, compassionate and effective support

CREDIT: This is an edited version of an article that originally appeared on MacMillan.org

Cancer does not happen in isolation. It affects people within the context of their lives, their histories and the wider systems around them – systems that can both support and harm. Every healthcare interaction is shaped by wider social factors such as inequality, discrimination, power imbalances and past experiences of care.

These factors can influence who is more likely to become ill, who gets diagnosed earlier or later, and who feels listened to and supported during their treatment. They can also affect how safe and confident people feel when accessing care. In cancer care, where fear, uncertainty and vulnerability are often high, these issues become even more important. People who are already marginalised by social or health inequalities may face additional barriers to accessing timely, respectful and effective care.

Using anti-oppressive, anti-racist and trauma-informed approaches in practices helps healthcare professionals recognise these barriers and respond in ways that improve experience and outcomes, while also supporting wider improvements in the healthcare system.

Anti-racist practice

Anti-racist cancer care recognises racism as a direct and ongoing determinant of health. It acknowledges that racism acts as a chronic stressor, a barrier to timely access, a contributor to delayed diagnosis and treatment, and a source of mistrust rooted in long histories of medical exploitation and neglect.

Practising anti-racism in cancer care means addressing both systemic and everyday forms of discrimination and shifting the focus away from perceived deficits within communities towards the structures that create inequity. In practice, this can involve developing culturally relevant screening programmes in partnership with trusted community organisations, and ensuring that communication, language and imagery reflect the communities they are designed to reach.

Anti-oppressive practice

Anti-oppressive practice begins with the understanding that disparities in cancer rates, screening uptake, diagnosis and treatment are not the result of individual behaviour alone, but are shaped by wider social, economic and political conditions.

It requires healthcare professionals and systems to actively recognise where power sits within clinical relationships and to consider how it can be more fairly shared. In practice, this may include involving people more meaningfully in decisions about their care, valuing lived experience alongside clinical expertise, and ensuring that cultural knowledge is respected and integrated into treatment planning.

Trauma-informed practice

Trauma-informed practice adds another essential layer. It recognises that trauma – whether individual, collective, intergenerational or structural – shapes how people engage with healthcare. While a cancer diagnosis and treatment journey can itself be traumatic, for many individuals and communities the trauma predates diagnosis, rooted in colonisation, forced displacement, systemic racism, medical abuse and ongoing social and economic inequality.

A trauma-informed approach therefore prioritises safety, trust, choice, collaboration and empowerment, recognising that how care is delivered is as important as what is delivered.

When brought together, these three approaches help shift cancer care beyond a purely clinical focus and towards a more holistic, people-centred model. For practice managers, this means recognising that effective care is not only about following clinical protocols, but also about the systems, processes and environments that shape each patient’s experience. It highlights the importance of embedding fairness, awareness of power dynamics, and respect for dignity into everyday practice operations, so that every interaction feels safe, inclusive and supportive.