MPs warn cancer survival risks going into ‘reverse’

Many lives will end “prematurely” due to a combination of a reluctance of some people to come forward and seek help for symptoms and delayed treatments during the Covid-19 pandemic, according to a new report.

Due to disruption caused by the pandemic, more people will not have their cancer diagnosed until it has reached a later stage – so it is harder to cure or treat, according to the Health and Social Care Committee of MPs.

Even during the latest wave of Covid-19, “vital” cancer surgeries have been cancelled which suggests the NHS is “still not able to access sufficient Covid-free treatment capacity to safeguard treatments and address the backlog”, they said.

Meanwhile, MPs on the committee warned that staffing shortfalls are “jeopardising” progress on diagnosing more cancers at an early stage.

The committee’s report on cancer services warns that there is no detailed plan to address shortages of clinical oncologists, consultant pathologists, radiologists and specialist cancer nurses.

Jeremy Hunt, chair of the committee and former health secretary, said: “Earlier cancer diagnosis is the key to improving overall survival rates however progress is being jeopardised by staff shortages which threaten both diagnosis and treatment.

“We do not believe that the NHS is on track to meet the Government’s target on early cancer diagnosis by 2028.

“We are further concerned at the damaging and prolonged impact of the pandemic on cancer services with a real risk that gains made in cancer survival will go into reverse.

“A mother told us of her 27-year-old daughter’s five-month struggle to get a diagnosis of cancer – tragically she died three weeks after it came. Unfortunately, many more lives will almost certainly end prematurely without earlier diagnosis and prompt treatment.

“That is why we are calling on the Government and the NHS to act now to address gaps in the cancer workforce upon which success depends. To date we have found little evidence of a serious effort to do so.”

The report states that despite NHS efforts to protect cancer services during the pandemic, 36,000 fewer people in England began cancer treatment compared to previous years.

Meanwhile, three million fewer people in the UK were invited for cancer screening between March and September 2020, while between March 2020 and March 2021, 326,000 fewer people in England received an urgent referral for suspected cancer.

And 4.6 million fewer key diagnostic tests were carried out, the report adds.

“The effect of reluctance to come forward, late diagnosis and delayed treatment will almost certainly mean that many lives will end prematurely,” the MPs warned.

Witnesses told MPs that they had to “ration treatment” and likened working in cancer services during the pandemic to “working 25 years ago”.

MPs also highlighted that thanks to pressures on GPs, family doctors may not spot as many potential cancer cases.

They said that urgent cancer referrals have begun to recover but key waiting time targets are being missed which risk “greater numbers of late diagnoses”.

They add: “Disappointingly, even the recent omicron wave of Covid-19 has seen more cancellations of vital cancer treatments indicating the NHS is still not able to access sufficient Covid-free treatment capacity to safeguard treatments and address the backlog.

“Without significant additional efforts, we conclude there is a real risk that the gains in cancer survival will reverse.”

The MPs said that the single best way to improve cancer survival rates would be to diagnose more cancers at an earlier stage but achieving ambitions to improve early detection rates will be difficult without sufficient staffing.

“Neither earlier diagnosis nor additional prompt cancer treatment will be possible without addressing gaps in the cancer workforce and we found little evidence of a serious effort to do this,” they wrote.

They warned that without proper workforce planning, the NHS will not achieve its ambition of diagnosing 75% of cancers at an early stage by 2028.

It said that without progress “more than 340,000 people between 2019 and 2028 missing out on an early cancer diagnosis”.

An NHS England spokesperson said: “Cancer is a priority for the NHS and has been throughout the pandemic – and we have continued to implement new ways to diagnose cancer earlier, including extending lung health checks in supermarket car parks, rolling out awareness campaigns to encourage people to get symptoms checked sooner, and trialling innovations like a blood test to detect more than 50 types of cancer before symptoms even appear.

“We have been seeing referrals for cancer checks at record highs for the last 11 months – with more than 567,000 people starting cancer treatment since the start of the pandemic – and by investing £3.8 billion in increased treatment and diagnostic capacity through the Elective Recovery Plan we aim to ensure that we are catching and treating more cancers at an early stage and saving even more lives.”

A Department of Health and Social Care spokesperson said: “We recognise that business as usual on cancer is not enough – that’s why we have redoubled our efforts and are developing a 10-Year Cancer Plan to set out how we will lead the world in cancer care.

“With record numbers of nurses and staff overall working in the NHS, we will tackle the Covid backlog and deliver long-term reform, including by reducing waiting times for cancer patients.

“We invested an extra £2 billion in 2021 and £8 billion over the next three years to cut the backlog and deliver an extra nine million checks, scans and operations by 2025. We will also deliver up to 160 community diagnostic centres across the country by 2025, 73 of which are open already.”