OCR GCSE Biology A: Non-communicable disease, cardiovascular treatment, lifestyle and cancer (J247) – Practice Questions

These are original questions written for Marlbridge, for revision and practice on this content. They are not reproduced past-paper questions, and they do not replicate the exam’s exact structure, question count or mark tariffs – examination boards hold copyright in their own papers. Use these alongside the official past papers from your board or school.

These questions cover statements B6.3r to B6.3u of module B6.3 in OCR GCSE (9-1) Gateway Science Biology A (J247), specification Version 4.0 (August 2026), for first assessment in 2018. None of these statements is in bold, so all questions suit both tiers. Learn the content from the study guide or the revision notes. Course pages: OCR GCSE Biology hub | checklist | all free 10-minute diagnostics.

Questions

1. Type 2 diabetes is described as a multifactorial disease. Explain what this means and give one example of a factor that can contribute. [2]

2. Region X has a population of 250 000 and recorded 190 new cases of type 2 diabetes in one year. Region Y has a population of 1.2 million and recorded 840 new cases.

(a) Calculate the number of new cases per 100 000 people in each region. [2] (b) State which region has the higher rate. [1]

3. Compare the use of a stent with a coronary bypass operation to treat coronary heart disease. [4]

4. The table shows invented data on lung cancer deaths among men of the same age.

Cigarettes smoked per day	0	10	20	30
Deaths per 100 000 men per year	14	80	150	240

(a) Describe what happens to the death rate as smoking increases. [2] (b) Calculate how many times higher the death rate is for men smoking 20 cigarettes per day than for non-smokers. Give your answer to 1 decimal place. [2] (c) Explain how substances in tobacco smoke can lead to lung cancer. [2]

5. Describe two differences between a benign tumour and a malignant tumour, and state what is meant by a secondary tumour. [4]

6. A tumour starts from one cell. Every cell divides by mitosis once every 16 hours.

(a) Calculate the number of cells after 18 divisions. [2] (b) Calculate how many days 18 divisions take. Give your answer to 1 decimal place. [2]

7. In a country, deaths from coronary heart disease fell from 310 per 100 000 people to 205 per 100 000 people over twenty years.

(a) Calculate the percentage change. [2] (b) Suggest two reasons for the change, one lifestyle-related and one medical. [2]

8. Two researchers want to find out whether regular exercise lowers the risk of type 2 diabetes. Researcher A asks 40 members of one gym about their health. Researcher B collects health and activity records from 1200 adults chosen at random from a national register. Evaluate the two plans. [4]

9. The table shows invented data from seven countries.

Sugary drink intake (mL per person per day)	20	45	60	85	110	140	170
Adults with type 2 diabetes (%)	4.1	5.0	6.2	7.4	9.0	10.1	12.3

(a) Describe how the two variables are related. [2] (b) Explain why these data alone do not prove that sugary drinks cause type 2 diabetes. [2] (c) Suggest what further evidence would make the conclusion stronger. [2]

10. (a) State what happens to the liver in cirrhosis. [1] (b) Explain how long-term heavy alcohol use can lead to cirrhosis. [2] (c) A country’s alcohol use rises sharply in one year, but cirrhosis cases do not rise until many years later. Suggest an explanation. [2]

11. A trial gave 800 patients a statin and 800 patients a placebo for five years. The table shows the results.

	Statin group	Placebo group
Mean blood LDL cholesterol at start (mmol/dm³)	4.4	4.4
Mean blood LDL cholesterol at end (mmol/dm³)	2.6	4.3
Patients with a heart attack	31	52
Patients reporting muscle pain	36	12

(a) Calculate the percentage change in mean LDL cholesterol in the statin group. [2] (b) Calculate the percentage of patients having a heart attack in each group. Give your answers to 1 decimal place. [2] (c) Evaluate the use of statins for patients with coronary heart disease, using the data and your own knowledge. [4]

12. Town C has a population of 30 000 and 45 new cases of type 2 diabetes in a year. Town D has a population of 20 000 and 24 new cases. The whole country has a population of 5 million and 9500 new cases.

(a) Calculate the rate per 100 000 for Town C and for Town D. [2] (b) Suggest two lifestyle-related reasons why Town C could have a higher rate than Town D. [2] (c) Calculate the national rate per 100 000 and state how the two towns compare with it. [2] (d) Explain one reason why comparing disease rates between countries is useful. [2]

Answers

1. It is caused by an interaction of several factors, not a single cause [1]. Example: a diet high in sugar, being overweight, lack of exercise, or inherited gene variants (any one) [1]. [2] Examiner insight: “Many causes” alone is often too vague. Naming one specific factor shows you know what the causes are.

2. (a) Region X: 190 ÷ 250 000 × 100 000 = 76.0 [1]. Region Y: 840 ÷ 1 200 000 × 100 000 = 70.0 [1]. [2] (b) Region X [1]. [1] Examiner insight: Region Y has more cases in total, which tempts a quick answer. Show the division for each region.

3. A stent is a mesh tube that holds the artery open from inside, with a smaller procedure and quicker recovery [1]. A clot can form on a stent or the artery can narrow again [1]. A bypass joins a vessel around the blockage and can deal with several blockages [1]. A bypass is major surgery with a longer recovery [1]. [4] Examiner insight: A comparison answer usually needs both treatments in the same sentence or paired points.

4. (a) As the number of cigarettes per day increases, the death rate rises [1], from 14 to 240 per 100 000 (quoting data) [1]. [2] (b) 150 ÷ 14 [1] = 10.7 times [1]. [2] (c) Chemicals in tobacco smoke damage the DNA of lung cells [1]. A mutation in genes controlling division can make cells divide uncontrollably, forming a tumour [1]. [2] Examiner insight: In “describe” questions, quoting figures from the table alongside the trend is good practice. In part (c), link smoke to DNA damage, then to uncontrolled division.

5. Benign tumours stay in one place and do not invade neighbouring tissue [1]; malignant tumours invade neighbouring tissue [1]. Malignant tumour cells can spread in the blood to other parts of the body but benign tumour cells do not [1]. A secondary tumour is a new tumour formed in another part of the body by cells that spread from the first tumour [1]. [4] Examiner insight: Make each difference a pair, one point for each tumour type. Saying only “malignant is worse” is too vague.

6. (a) Cells = 2¹⁸ [1] = 262 144 [1]. [2] (b) 18 × 16 = 288 hours [1]; 288 ÷ 24 = 12.0 days [1]. [2] Examiner insight: A common slip is multiplying 20 by 2 instead of using a power of 2 in part (a). In part (b) the question asks for days, not hours.

7. (a) Change = 205 − 310 = −105 [1]. (−105 ÷ 310) × 100 = −33.9% (a fall of 33.9%) [1]. [2] (b) Lifestyle: fewer people smoke, or healthier diets, or more exercise (any one) [1]. Medical: use of statins, stents or bypass surgery, or drugs to lower blood pressure (any one) [1]. [2] Examiner insight: Divide by the original value, not the new one. Stating “fall” or a minus sign shows you have read the direction correctly.

8. Researcher B’s sample is much larger [1] and chosen at random, so it is more representative of the population [1]. Researcher A’s sample of 40 gym members is small and biased towards people who are already active, so it cannot show the effect of exercise on the whole population [1]. Researcher B’s plan is better, though neither design controls for diet, age or inherited risk [1]. [4] Examiner insight: “Evaluate” needs a judgement. State which plan is better and why, then add one remaining limitation.

9. (a) Positive correlation: as sugary drink intake rises, the percentage with type 2 diabetes rises [1], from 4.1% at 20 mL to 12.3% at 170 mL (quoting data) [1]. [2] (b) A correlation does not show cause [1]. Other factors, such as total diet, activity levels or wealth, may differ between the countries and explain the pattern [1]. [2] (c) A biological mechanism for how excess sugar leads to the disease [1]. Studies that follow individuals over years and control other factors such as exercise and total energy intake [1]. [2] Examiner insight: Strong answers name a specific alternative factor rather than writing “other variables”.

10. (a) Healthy liver tissue is replaced by scar tissue [1]. [1] (b) Alcohol is broken down in the liver, so heavy drinking exposes liver cells to damage [1]. Over a long time the damaged cells are replaced by scar tissue [1]. [2] (c) The damage builds up over many years [1], so cirrhosis appears only after long-term heavy drinking [1]. [2] Examiner insight: Mentioning the time delay is the key idea in part (c).

11. (a) Change = 2.6 − 4.4 = −1.8 [1]. (−1.8 ÷ 4.4) × 100 = −40.9% [1]. [2] (b) Placebo: 52 ÷ 800 × 100 = 6.5% [1]. Statin: 31 ÷ 800 × 100 = 3.9% [1]. [2] (c) Statin lowered cholesterol by 40.9% while placebo group cholesterol hardly changed [1]. Heart attacks fell from 6.5% to 3.9% of patients [1]. Muscle pain was more common with statins (36 compared with 12 patients) [1]. Judgement: benefits seem to outweigh the side effects for most patients, but the trial lasted five years and patients should be monitored, and lifestyle change is still needed [1]. [4] Examiner insight: Use figures from the table on both sides of the argument. A conclusion that depends on the patient reads as a stronger evaluation than a flat yes or no.

12. (a) Town C: 45 ÷ 30 000 × 100 000 = 150.0 [1]. Town D: 24 ÷ 20 000 × 100 000 = 120.0 [1]. [2] (b) More people eat a high-sugar or high-fat diet [1]. Less regular exercise (accept more people who are overweight) [1]. [2] (c) National: 9500 ÷ 5 000 000 × 100 000 = 190.0 per 100 000 [1]. Both towns have a lower rate than the national rate [1]. [2] (d) Countries with lower rates may show which lifestyle or health policies reduce disease [1], and rising rates in one country can warn others to act early [1]. [2] Examiner insight: Convert to a rate before comparing places of different sizes. In part (b), tie each factor to the disease for full effect.

Where marks are usually lost

• Comparing totals of cases instead of rates per 100 000.
• Dividing a percentage change by the new value rather than the original value.
• Writing “it causes” from a correlation with no further evidence.
• Evaluating a treatment with advantages only, or with no judgement at the end.
• Calling a statin or stent a cure, when they manage the condition.
• Mixing up benign and malignant tumours, or forgetting secondary tumours.
• Writing that cancer is infectious or always inherited.

Next steps

• Revise with the revision notes.
• Go back to the study guide.
• Visit the OCR GCSE Biology hub and the printable checklist.
• Try all free 10-minute diagnostics.
• Book a free trial class.

Official syllabus

OCR GCSE (9-1) Gateway Science Biology A (J247), specification Version 4.0 (August 2026), for first assessment in 2018, published by OCR.