Almost 40,000 cancers went undiagnosed during the first year of Covid, official figures revealed today, laying bare the ‘true and catastrophic impact’ of the pandemic.
Just 290,000 people in England were told they had cancer in 2020, down by a tenth on one year earlier — the biggest drop logged since records began 50 years ago — and the lowest number logged in a decade.
It means 100 fewer Britons daily were told they had cancer, equating to one every 13 minutes — leaving experts worried about a cancer time bomb. Half of the missed tumour are thought to be prostate and breast cancers.
The NHS prioritising Covid care, a lack of in-person appointments and the public avoiding the health service due to fear of catching the virus or adding to NHS pressures have all been blamed for the downturn.
Experts warned the 40,000 missed cancers is just the ‘tip of the iceberg’, as the backlog in diagnosis is ‘still present and actually growing’ — with tens of thousands facing ‘agonising’ delays.
Covid disruption means more Britons are living with missed and untreated serious cancers — which will cause the cancer death to shoot up within years, top cancer doctors said.
It comes as latest health service data shows that while record cancer checks were carried out in August, patients are not being tested or starting treatment fast enough.
Just 290,000 people in England were told they had cancer in 2020, down by a tenth on one year earlier — the biggest drop logged since records began 50 years ago — and the lowest number logged in a decade
The graph shows the number of new cancer diagnoses in England between January 2019 and June 2020. In April 2020, in the early days of the pandemic, new cancer diagnoses fell to 17,039, down by a third compared to 24,802 in March 2020
In August, NHS England performed a record number of cancer checks. However, the graph shows the health service still failed to hit a key target to start treatment for the disease within two months of an urgent referral (red line) and near-record numbers of people were left waiting more than two months to have cancer ruled out or confirmed (blue lines)
NHS England figures show the five-year survival rates for different types of cancer. Rates are highest for lung, stomach and colon cancer
The NHS Digital data shows there were 288,753 new cancer diagnoses in 2020, which is 38,421 fewer than in 2019.
The 2020 figure marks an 11.7 per cent drop — the biggest logged by the NHS in its 50 years of cancer diagnoses data. Until now, the largest annual decline was 7.1 per cent in 1990.
New diagnoses had been trending upwards, with 2 per cent more cancers spotted each year, on average, in the five years before the pandemic.
But the latest data shows that the average number of new diagnoses each day fell from 896 in 2019 to 789 in 2020 — 107 fewer.
Rather than the prevalence of cancer declining in the population, more cancers were missed in 2020 as the country was plunge into lockdowns.
Cancer care was effectively ground to a halt for some patients when the pandemic first reached the UK’s shores, with appointments cancelled and diagnostic scans delayed because of the Government’s devotion to protecting the NHS.
The 2020 cancer data also revealed that the drop-off in cancer diagnoses was unevenly spread.
While the rate fell by 11.7 per cent year-on-year across all cancers, the number of people diagnosed with prostate cancer fell by 24 per cent, with 11,463 fewer people diagnosed.
Among women, 8,175 fewer breast cancers were diagnosed (17 per cent drop), while 1,319 melanomas are thought to have been missed (18 per cent fall).
The number of people diagnosed with cancer has been trending upwards
The figures also confirm that prostate, breast, bowel and lung cancer continue to make up more than half of all those diagnosed.
And men are still to be more likely to be told they have a tumour, with 148,210 diagnosed in 2020, compared to 140,543 among women.
While cancer rates are higher among women aged 15 to 59 but the trend reverses among the over-60s.
Around a quarter of all tumour diagnoses among men were prostate cancer (24 per cent), which is a similar rate seen among breast cancer rates among women (28 per cent).
Meanwhile, the cancer fatality rate fell by one per cent between 2019 and 2020.
The risk of a man dying from the disease fell from 307 per 100,000 people to 303 per 100,000. Among women, the rate fell from 216 to 214 per 100,000.
The poorest in England were most likely to die from cancer, with fatality rates 53 per cent higher among the poorest fifth of people compared to the richest fifth.
Minesh Patel, head of policy at Macmillan Cancer Support, said: ‘We have been sounding the alarm on the impact of the backlog for two years now, but it does not make it any easier to see the true and catastrophic impact of the pandemic laid bare like this.
‘Today, delays in being diagnosed and treated for cancer remain an agonising reality for tens of thousands of people.
‘There simply aren’t enough professionals to care for people living with cancer, and despite their best efforts, this is leaving existing staff struggling under ever-increasing workloads. This is unsustainable, and unsafe.
‘Every person who waits too long to hear the lifechanging news that they have cancer is also faced with a potential risk to their chances of survival.
‘This is devastating and frightening for cancer patients and can have a real impact on their mental health and wellbeing. It doesn’t need to be this way.
‘It’s astounding that the UK Government has not yet committed to addressing the gravity of the challenges facing cancer care. We need assurances now that funding for cancer services will be protected.
‘We cannot afford for people living with cancer to be forgotten any longer.’
Professor Karol Sikora, consultant oncologist and founding dean at the University of Buckingham Medical School, told MailOnline: ‘I’m very concerned this just represents the tip of the iceberg of cancer numbers.
‘The backlog in diagnosis is still present and actually growing.
‘Although the death rate was lower last year it will almost certainly take two to three years for the effect of missing cases to show up in the mortality figures.
‘I am truly shocked that the politicians have not put more emphasis on getting cancer diagnosed and treated.’
New Health Sectretry Thérèse Coffey last month unveiled her ‘ABCD’ list of priorities for the health service, promising to put ambulances, backlogs, care, doctors and dentists at the top of her agenda — leaving cancer off the list.
Professor Sikora added: ‘What is it they don’t understand? More people will die because of the lockdowns and their consequences compared to Covid.
‘And those that lobby for further restrictions as the infection rate increases need to get a sense of balance. Its not just cancer patients that suffer but those with a range of other conditions too.’
Despite being more than two years on from the pandemic, official figures show the health service’s cancer performance is near record lows.
In August, 255,055 people had a cancer check following an urgent GP referral, the highest number since records began.
The health service attributed this in part to the ‘Deborah James’ effect encouraging people to get checked for bowel cancer following the campaigner’s death earlier this year.
However, the NHS continued to fail to hit its cancer treatment targets in August.
Only three-quarter those who received an urgent cancer check got it within two weeks. The health service’s own rulebook states that 93 per cent of people should be seen within this timeframe.
And too many cancer patients faced long waits treatment for the disease, with nearly four in 10 not starting treatment within two months. Some 85 per cent are supposed to start treatment in this time frame.
Experts have warned of a ‘vicious circle’ of patients with cancer symptoms being unable to get a GP appointment, or believing they can’t bother the NHS.
Once they are seen, there are mammoth delays for referrals for vital tests, biopsies and scans, followed by even more waits for surgery and radiotherapy, according to cancer doctors who warn the delays are only getting worse.
For every four weeks that a cancer patient’s treatment is delayed, their chance of surviving falls by 10 per cent.
And if their cancer has spread to another part of their body while they wait, it may be incurable, potentially rendering surgery, chemotherapy and radiotherapy ineffective.
On top of this, patients with this late-stage cancer require more support from the NHS, which reduces its capacity to treat other cancer patients.
Professor Justin Stebbing, an oncologist at Imperial College London and editor of cancer journal Oncogene, told MailOnline that ‘many things’ in the pandemic contributed to the drop-off in screening and diagnoses.
Lockdowns, stay-at-home orders, people’s fear of infection and hospitals and people avoiding seeking medical treatment that they thought was non-urgent all played a part, he said.
As did limited access to in-person medical examinations and the reorganisation of hospital departments, Professor Stebbing noted.
He said: ‘Such disruption in care will have both short and long term consequences and the specific issue here that is most relevant is an increase in death rate, due to untreated missed serious cancers.
‘Public health measures should be implemented in this country to mitigate the deleterious effects of this health crisis on the diagnosis of cancer.’
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