Coronavirus crisis could cause thousands of avoidable cancer deaths in England over next five years

Some 3,500 patients could die of potentially preventable cancers in England by 2025
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Thousands of Britons could die of preventable cancers over the next five years because of delays in diagnosis caused by the coronavirus pandemic, experts have warned.

Researchers calculated that there could be about 3,500 potentially avoidable deaths from breast, bowel, oesophageal and lung cancer in England alone.

A drop in the number of people with symptoms visiting their GPs and lower referrals for scans, could mean cancers are spotted too late, research published in The Lancet Oncology suggests.

Even when patients are referred to hospitals, they are increasingly having to wait to access life-saving diagnostic services, the study warned.

Dr Ajay Aggarwal, from the London School of Hygiene and Tropical Medicine in London, who led the research, said: “Our findings estimate a nearly 20 per cent increase in avoidable bowel cancer deaths due to diagnostic delays.

“To prevent this becoming a reality, it is vital that more resources are made urgently available for endoscopy and colonoscopy services which are managing significant backlogs currently, and that patients present promptly to their GP if they have any concerning gastrointestinal symptoms.”

NHS figures show that 106,535 urgent cancer referrals were made by GPs in England in May 2020, down from 200,599 in May 2019 – a fall of 47 per cent.

At the same time, 55,500 more people are now waiting to have key cancer tests in the country’s hospitals compared with the same point last year.

For the study, experts carefully estimated the number of deaths that could be caused by disruption to cancer services and people failing to seek help due to the Covid-19 crisis.

On average, for each avoidable cancer death due to a diagnostic delay, 20 years of life will be lost, with a substantial proportion of deaths in younger or middle-aged people, they said.

Overall, breast cancer deaths could rise by eight to 10 per cent (281 to 344 more deaths by 2025) and bowel cancer deaths by 15 to 17 per cent (1,445 to 1,563), experts said.

There could also be a five per cent (1,235 to 1,372) rise in lung cancer deaths, and a six per cent (330 to 342) rise in deaths from oesophageal cancer over the next half-decade.

Professor Richard Sullivan, from King’s College London, who also worked on the study, said: “These estimates paint a sobering picture and reflect the many young people who are affected by cancer in the prime of life during their most productive years.”

The authors warned the true death toll could be far higher once all types of cancer were factored in together with delays in treatment for those already diagnosed with cancer.

For a separate study in the same journal, the Institute of Cancer Research (ICR) examined data for 20 common cancers.

At present, anyone with suspected cancer is supposed to be seen by a specialist in hospital within two weeks of referral by their GP.

But the new ICR modelling looked at the impact of three different scenarios of lockdown-accumulated backlog – reflecting a 25 per cent, 50 per cent or 75 per cent reduction in presenting with symptoms and receiving urgent GP referrals over a three-month lockdown period.

The data suggested that if all patients eventually sought help and were referred for scans or other tests promptly at the end of lockdown in mid-June, there could be between 181 and 542 excess deaths.

However, even more lives will be lost when delays in accessing scans and biopsies in a timely fashion are added to the totals.

The ICR team estimated that a one month per patient delay in diagnosis just via the two-week GP referral pathway would result in 1,412 lives lost, while a six-month delay would result in 9,280 lives lost.

When it came to cancer type, the ICR said delays for suspected bladder, kidney and lung cancers would have the biggest impact on the number of lives lost.

Study leader Professor Clare Turnbull said: “It’s vital that we do everything we can to ensure cancer patients are not left further behind by the disruptions to care caused by the Covid-19 pandemic.

“That means ramping up capacity as quickly as possible to allow cancer diagnostic services to clear the backlog.”

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