THE stark geographical divides in the nation’s health and the devastating effects of smoking and drinking are revealed today in an atlas of cancer in the British Isles.

The 400-page atlas, the largest study to date of geographical disparities in the prevalence of different cancers, identifies areas such as northern England and Central Scotland where rates are far higher because of unhealthy lifestyles.

People living in these communities, often in working-class industrial areas, are shown to be more likely to die of cancers of the lung, voice box, lip, mouth and throat — diseases linked to excessive alcohol and smoking.

The atlas provides further damning evidence of the health divide between the North and South of Britain and the strong association with poverty and social deprivation. Rates for deaths and new cases were generally three times higher in the most deprived areas than the most affluent. Experts said that if all cancer rates were reduced to the level of the lowest areas, it would save at least 17,000 lives a year.

The atlas, which covers the UK and Ireland and is published by the Office for National Statistics, also indicates high rates of skin melanoma in the South West of England, a trend linked to greater exposure to the sun. Incidence of the cancer was also higher than average in Scotland and Ireland, but the regions had lower than average death rates. This was attributed to a greater awareness among the communities of the impact of sun on pale complexions, prompting earlier skin cancer detection.

The map also shows large variations in the incidence of cervical cancer, with much higher than average rates in the urban West Midlands, in a band across the North of England, and parts of Scotland. Cervical cancer is directly related to sexual activity, as it is triggered by a sexually transmitted virus.

Analysts said that there was again a strong correlation between high rates of the cancer and living in deprived areas.

Mike Quinn, one of the authors, said that it should be possible to cut all rates significantly, preventing or avoiding 25,000 cancer cases and 17,000 deaths a year. “Places do not get cancer, people do,” he said. “The reason areas have high rates of cancer is that people in them are exposed to the relative risk factors for those cancers.”

Incidence rates for oesophagus, or gullet, cancer were noticeably higher than average in much of northern England and Scotland, the atlas showed. In contrast, there was little geographical variation in the number of cases of breast, ovary and prostate cancers. Only small differences in incidence and mortality existed for bowel and pancreatic cancer, and these were not strongly related to socioeconomic factors.

The incidence of stomach cancer was higher than average in parts of London and the urban West Midlands, in bands across northern England and Central Scotland, and in Belfast and Dublin. Stomach cancer, which is related to diet, was about twice as common in deprived areas as in affluent regions.

The atlas contains numerous colour-coded maps showing the distribution of 21 of the most common cancers between 1991 and 2000. It is the first attempt to map cancer trends for the UK and Ireland.

Nationally, the new atlas shows that cancers of the lung, breast, prostate and bowel make up about 50 per cent of total cases and deaths.

Lesley Walker, the director of cancer information at Cancer Research UK, said that the data backed the pressing need for a smoking ban in enclosed public places and an end to health disparities.

She said that half of all cancers, equivalent to about 135,000 cases a year, could be prevented by changes to lifestyle.

The Department of Health said that the statistics would help the NHS to form a baseline against which the success of its NHS Cancer Plan could be measured. Since 1997 there has been a 12 per cent reduction in cancer deaths and the Government hopes to reach the 20 per cent mark by 2010.

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