The UK’s ‘emergency’ cancer battle

More than a third of cancer cases in Britain are only diagnosed after visits to accident and emergency (A&E) departments, new research has found.

The study, published in The Lancet, examined more than 850,000 patients comparing hospital admissions from 14 areas in six comparable high-income countries and found that Britain is “among the worst in the world at detecting cancer early,” said The Telegraph.

Experts described the figures as “worrying”, the paper added, citing “fears the situation could worsen in coming years because of backlogs built up during the pandemic”.

Second-bottom Britain

The report by the International Cancer Benchmarking Partnership and Cancer Research UK (CRUK) found the UK came second from bottom in terms of early cancer diagnosis. Only New Zealand had a higher proportion of diagnoses made in A&E departments.

In total, 37% of patients in England and Wales and 39% of those in Scotland were only diagnosed after being taken to hospital. In New Zealand the rate was 42.5%.

When looking at specific cancer diagnoses, 46% of all cases of pancreatic cancer were spotted only in an emergency. This figure was much higher in Britain, at 56% in England and Wales and 59% in Scotland. 

A total of 34% of people in England and Wales and 35% in Scotland were diagnosed with bowel cancer in an emergency setting, while 47% of people in the UK were diagnosed with liver cancer in A&E.

The data was collected between 2012 and 2017, with CRUK warning that the outlook could have become worse since then due to disruptions caused by the pandemic.

What is being done?

Responding to the findings, Michelle Mitchell, CRUK’s chief executive, said: “We’d like to see governments across the UK take bold action on this within their cancer plans so that by 2032, fewer than 10% of cancer cases are diagnosed through emergency routes.

“If we want to build a world-class cancer service, we need to learn from comparable countries and ensure fewer patients are being diagnosed with cancer after an emergency referral or trip to A&E.

“The UK is already lagging when it comes to cancer survival – this study helps us understand why, showing that countries with higher levels of emergency presentations have lower survival.”

Last spring, the NHS in England introduced a new measure called the Faster Diagnosis Standard (FDS). It set a target of 75% of patients getting a cancer diagnosis, or having cancer ruled out, within 28 days of being urgently referred by their GP for suspected cancer.

But CRUK said that in the longer term, it hopes that NHS England will set the FDS on a “more ambitious trajectory” to ensure even more patients will receive a timely diagnosis. It is calling for the target to be raised from 75% to 95%.

A Department of Health spokesperson told the BBC it recognised “business as usual is not enough” and said it was developing a new ten-year cancer plan. But, it added, progress was already being made, with a network of 160 new diagnostic centres being opened.

An NHS spokesperson told The Telegraph that “the proportion of cancer patients who are diagnosed through an emergency route has been falling steadily” since 2017.

“NHS staff have been referring more people for urgent cancer checks over the last 11 months than ever before, with more than 200,000 patients checked in January alone,” they added.