Cancer is a dread disease, and cancer prevention a high priority for governments and non‐governmental organizations. The most common cancer prevention activities aim to modify “behavioral risk factors” in populations and to screen for early‐stage cancer or pre‐cancer to enable early treatment. Cancer incidence, service utilization, and outcomes are associated with social, cultural, and economic disadvantage, leading to a desire to increase cancer screening service utilization in disadvantaged communities. However the epidemiology of cancer screening increasingly suggests that some forms of screening do more harm than good, contradicting public enthusiasm for this service. Paradoxically, this means that disadvantaged people may be better off, on average, if they do not participate in some forms of cancer screening. The large and convincing literature on the social determinants of health suggests the importance of improving living conditions and access to resources for disadvantaged people as a strategy for cancer prevention.