A record number of people with suspected cancer are being referred by their GPs to specialists, but the NHS has not been able to keep up with increased demand.
More than two and a half million people in England were referred for suspected cancer in the year to April 2022, 300,000 more than the previous record set two years ago and more than double the amount from ten years ago.
But the number of exploratory tests which typically confirm or rule-out a cancer diagnosis are down on pre-pandemic levels and in some cases the lowest since records began in 2009.
Cancer Research UK told Sky News that the lack of capacity for tests like endoscopies was preventing the NHS from extending its cancer screening programme to younger age groups.
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One measure of a public health system’s effectiveness is that a higher percentage of cancers are diagnosed via a “managed” route rather than in an emergency. For example when people visit their GP rather than turning up at A&E.
It’s not always possible to avoid an emergency diagnosis, but in general those cases spotted by GPs are at an earlier stage and have a better survival rate.
Search for your GP surgery below to see the number of cancer cases and what percentage were picked up in a managed route, compared with your local area and England.
Bowel cancer
The issues facing NHS cancer care are best typified by bowel cancer.
New tests have been rolled out which check for signs of blood in faeces, and these can be carried out at home – called FIT tests. That means at-risk people are being better targeted for check-ups.
The number of people going for bowel cancer screenings is also at a record level, thanks in part to the campaigning of Dame Deborah James. So the initial part of the process – the messaging, and making sure the right people are seeking care – is working well.
But Cancer Research UK told Sky News that the government has not increased diagnostic capacity in line with this, in terms of both staffing and equipment.
There are NHS staff shortages of endoscopists, radiologists and pathologists, which are all key in diagnosing bowel cancer.
“What we’re seeing in the NHS is services being overwhelmed by the number of people coming through,” said Naser Turabi, Director of Evidence and Implementation at Cancer Research UK.
“COVID did cause problems but this is part of a longer term trend. At the moment we are actually holding back on lowering the age for bowel cancer screening because there isn’t enough endoscopy capacity.
“Often the treatment you need is just the colonoscopy itself, where you can snip off any worrying signs.
“But if you go [for a colonoscopy] at a later stage then the treatment for bowel cancer can be really significant and invasive and include things like chemotherapy and radiotherapy.”
Genevieve Edwards, Chief Executive of Bowel Cancer UK, told Sky News that this is particularly significant for bowel cancer – there is a 97% survival rate for people diagnosed at Stage 1, compared with just 8% of those diagnosed at Stage 4.
NHS data published last month showed that in September more than one in four people had to wait over two weeks to see a cancer specialist after being urgently referred by their GP. That’s almost four times more than the NHS target.
Read more:
NHS cancer treatment waiting times at record high – how bad are they and why?
Key target for waiting times on cancer treatment missed in 98% of NHS England areas
Alongside a workforce plan, Bowel Cancer UK is calling for investment in better equipment.
“There’s a pilot ongoing for colon capsule endoscopy – a pill cam – a little camera you swallow accompanied by a monitor you wear around your waist. It takes two pictures a second for 24 hours and that can take pressure off endoscopy services.”
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