Cancer undiagnosed 'for nearly 2,000 people in UK every week'

Cancer is going undiagnosed for up to 2,000 people a week due to Covid-19 concerns in hospitals and GP surgeries, with a charity warning the UK now faces a “ticking time bomb”.

Macmillan Cancer Support said the disease risks becoming “the forgotten C” of the coronavirus pandemic, with evidence of patients having appointments cancelled or postponed, while others awaiting possible diagnosis say they are put off attending hospitals due to concerns about contracting the virus.

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It follows a study from the Institute of Cancer Research, London, that suggested putting off cancer surgeries for three months could lead to almost 5,000 excess deaths in England alone.

A survey of 100 cancer patients who support Macmillan’s campaigning work showed almost half (45%) had seen their cancer treatment delayed, cancelled or changed as a result of coronavirus.

Steven McIntosh, Macmillan Cancer Support policy director, said: “We’ve seen a very worrying drop in the number of people coming forward with suspected cancer symptoms to be referred for diagnosis by their GPs.

“We estimate that disruptions to GP referrals – screening programmes – could mean as many as 1,900 cases of cancer a week are currently going undiagnosed.

“That’s why we’re warning that the size of this ticking time bomb is deeply worrying for people who are living with cancer but also for storing up huge problems for the NHS in trying to diagnose and treat cancer, when we have also seen significant disruption to cancer surgery, chemotherapy, and radiotherapy.”

The 1,900 figure is based on evidence given to Parliament last month by Dame Cally Palmer, national cancer director for NHS England, who said that two-week referrals - where GPs send patients with suspected cancer to specialists for further investigation - were down by almost two-thirds.

Macmillan is calling on the government to set out clear plans for restoring cancer care that clarify how cancer patients will have access to timely diagnosis and treatment, with surge capacity to catch up on the backlog of care coronavirus has caused.

Prof Charles Swanton, chief clinician at Cancer Research UK, who is leading the Covid-19 testing laboratory at the Francis Crick Institute, said that late diagnosis is a major concern and that Covid protected zones need to be urgently established in hospitals to allow cancer screening and treatment to restart.

“We need to build confidence back in the system so that patients can be seen safely, treated and protected,” he said. This would require widespread, routine, rapid testing of healthcare workers and routine testing of patients on admission.

“We basically need to make Covid testing part of the fabric of modern life until this is in the distant past,” he said.

An analysis of official health data by Macmillan also suggested that cancer deaths may already have increased due to disruption to care caused by Covid-19. It found that in England and Wales there were at least 500 more deaths from cancer than average in March and April this year.

McIntosh said: “Macmillan is deeply concerned that the impact of the pandemic is really going to wreak havoc in the progress we’ve made in improving cancer care in the UK, in both the public’s willingness to come forward with symptoms because they’re nervous about the medical system, and in the risk of disruption to treatment and cancer surgery.

“That’s why it’s so important that we send out a strong message to the public: you’ve got to come forward with cancer symptoms, and that governments demonstrate we have cancer care back on track, being delivered safely.

“We need to catch up with treatment so that we don’t see a serious spike in cancer deaths and we prevent people living anxiously in fear of both coronavirus and undiagnosed cancer.”

Swanton said that clearing the backlog of missed appointments and delayed treatment would be a major challenge in the coming months. “The system is stretched even in peacetime,” he said. “My concern is the NHS is going to be very stretched at the point when normal work resumes.”

The charity saw a rise in demand for a number of its services and has launched new virtual ones – such as telephone buddying –to prevent people with cancer from falling through the cracks.

However, the charity said it is facing an income loss of up to 50% for this year.