The U.K. authorities are failing to acknowledge or deal effectively with an epidemic of work-related cancers. The government's Health and Safety Executive (HSE) underestimates the exposed population, the risks faced as a result of those exposures, and the potential for prevention. The HSE fails to acknowledge the social inequality in occupational cancer risk, which is concentrated in manual workers and lower employment grades, or the greater likelihood these groups will experience multiple exposures to work-related carcinogens. It continues to neglect the largely uninvestigated and unprioritized risk to women and currently has neither a requirement nor a strategy for reducing the numbers and volumes of cancer-causing substances, processes, and environments at work. The result is that the U.K. faces at least 20,000 and possibly in excess of 40,000 new cases of work-related cancer every year, leading to thousands of deaths and an annual cost to the economy of between pounds 29.5bn and pounds 59bn. This paper outlines flaws in the HSE's approach and makes recommendations to address effectively the U.K.'s occupational cancer crisis.