Where cancer patients live could influence late diagnosis

Cancer Research UK

The Lump | Cancer Research UK

If all the regions of England were as good as the South West at diagnosing cancer early nearly 20,000 more patients over two years could be diagnosed at stage 1 or 2, giving them a better chance of survival.* (Table 1)

The biggest difference in stage at diagnosis among all cancers across England in 2012-13 was between Merseyside and the area incorporating Bath, Gloucestershire, Swindon and Wiltshire.

“Wherever you live, an early diagnosis of cancer will give you more treatment options and a better chance of survival." - Sara Hiom, director of early diagnosis, Cancer Research UK

Almost half the cancer patients in Merseyside (49 per cent) are diagnosed late compared to 40 per cent of patients in the South West, according to a Cancer Research UK analysis of data that recorded the stage of diagnosis in around two-thirds of all cancer cases in England.

These areas show the biggest percentage difference in stage at diagnosis among all cancers across England from 2012-13. If Merseyside reached the level of the South West almost 1,000 more of all its cancer patients would have had an earlier diagnosis and a greater chance of beating their disease.

In breast cancer the figures show that, where staging data has been recorded, almost a quarter of breast cancer patients in London were diagnosed late compared to just 10 per cent in Leicestershire and Lincolnshire. This equates to around 1,000 London breast cancer patients missing out on an earlier diagnosis.** (Table 2)

And with bowel cancer, Merseyside came bottom in England again with almost 60 per cent of patients diagnosed late compared with half of bowel cancer patients in East Anglia, which came top. This equates to almost 140 Merseyside patients missing the chance of their bowel cancer being diagnosed earlier.

"We've made good progress during the last seven years. But these figures show much more needs to be done to give patients the best chance of surviving their disease in all areas of the country." - Harpal Kumar, Cancer Research UK’s chief executive

These statistics are released as Cancer Research UK launches a nationwide Early Diagnosis Campaign next week. The campaign will encourage people to know what’s normal for their bodies so they spot unusual changes and see their GP about possible cancer symptoms without delay. Survival for some of the most common types of cancer is known to be more than three times higher when the disease is diagnosed in the earlier stages.***

Analysts looked at available data on 10 types of cancer across 25 areas of England in 2012 and 2013, and whether the disease was diagnosed early – at stage 1 or 2 – or later, at stage 3 or 4.

They found that people’s chances of being diagnosed early could also depend on which cancer they have, with areas that were among the best for diagnosing one type of cancer early not always doing as well when it came to other types of the disease. For example, although East Anglia was the best place for detecting bowel cancer at an early stage, it was almost the worst for spotting melanoma skin cancer early.

Dr Jodie Moffat, head of early diagnosis at Cancer Research UK, said: “We don’t know for sure why there’s such variation across England and it’s likely that a lot of factors are coming into play. These might include patients not going to their doctor as early as they could with possible cancer symptoms, and GPs sometimes failing to suspect cancer or not referring patients for diagnostic tests promptly.”

Staging information was not recorded at the time of diagnosis in around a third of all cancer cases in 2012 and 2013. But the Cancer Research UK analysis suggests that this would not change the overall picture.

Sara Hiom, director of early diagnosis at Cancer Research UK, said: “Wherever you live, an early diagnosis of cancer will give you more treatment options and a better chance of survival. So it’s unacceptable to see such variation across England, with some areas falling far behind others in prompt diagnosis of different cancers. The available data indicate widespread problems, with far too many patients being diagnosed later than they should be.

“It’s not easy to make sure that all cancer patients are diagnosed as early as possible, but it’s vitally important. We need to ensure that people with unusual or persistent changes to their bodies seek help rather than ignoring or putting up with potential cancer symptoms. And we need a system where GPs are supported in the diagnosis of cancer and there are the resources to ensure patients can be investigated promptly. The new cancer strategy makes clear recommendations on how we can improve England’s cancer survival, and improvement is needed across the whole of the UK.”

Ahead of the National Cancer Research Institute’s annual cancer conference in Liverpool, Harpal Kumar, Cancer Research UK’s chief executive and chair of the National Awareness and Early Diagnosis Initiative, said: “Ensuring patients have an early diagnosis is a top priority for Cancer Research UK. We've made good progress during the last seven years. But these figures show much more needs to be done to give patients the best chance of surviving their disease in all areas of the country.

“The Government has promised to act on the recent cancer strategy for England, which I published in the summer. I urge it to commit to the full package of recommendations as quickly as possible to get the best possible outcomes for all cancer patients.”

ENDS

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Notes to Editor

*Table 1 showing the 25 regions of England ranked by percentage of late stage diagnoses of all cancers, from lowest to highest

Regions of England

Percentage of late stage diagnoses (2012-13)

Number of cases late stage diagnoses (2012-13)

Number of staged diagnoses (2012-13)

Number of patients who could have had an early diagnosis if their area equalled the best in England (2012–13)

Bath, Gloucestershire, Swindon and Wiltshire

40.26

4631

11199

N/A

Devon, Cornwall and Isles of Scilly

43.21

6698

15502

457

East Anglia

43.92

10658

24385

841

Bristol, North Somerset, Somerset and South Gloucestershire

44.09

5002

11426

402

Arden, Herefordshire and Worcestershire

44.1

5042

11372

464

Hertfordshire and the South Midlands

44.48

8412

19511

557

Thames Valley

44.62

4299

9988

278

Derbyshire and Nottinghamshire

44.79

5726

12563

668

Leicestershire and Lincolnshire

44.9

4521

9929

523

Cheshire, Warrington and Wirral

45

5213

11437

608

Wessex

45.04

9675

22054

796

Essex

45.06

6833

15428

622

Birmingham and the Black Country

45.49

7936

17519

883

Surrey and Sussex

45.74

8148

17797

983

North Yorkshire and Humber

46.22

5606

12305

652

Lancashire

47.07

6062

12816

902

Cumbria, Northumberland, Tyne and Wear

47.15

7067

15176

957

London

47.21

17544

37346

2509

Shropshire and Staffordshire

47.23

5785

12277

842

West Yorkshire

47.57

7206

15033

1154

Kent and Medway

47.64

5506

11758

772

South Yorkshire and Bassetlaw

47.92

4307

8979

692

Durham, Darlington and Tees

47.94

4309

8927

715

Greater Manchester

48.08

10323

21526

1657

Merseyside

48.77

5376

10949

968

 

**Table 2 showing best and worst regions of England for significant individual cancers in 2012-13 

Cancer

Area Team

Percentage of staged cancers diagnosed late (stage 3 or 4)

Number of cases diagnosed at late stage for 2012 + 2013

Number of staged cases for 2012 + 2013

Number of patients who could have had an early diagnosis if their area equalled the best in England (2012–13)

Breast

Leicestershire and Lincolnshire (best)

10%

222

2106

1010

London (worst)

22%

1804

8192

 

Colorectal (bowel)

East Anglia (best)

50%

1752

3372

139

Merseyside (worst)

59%

913

1551

 

Malignant Melanoma

Durham, Darlington & Tees (best)

4%

11

257

45
 

West Yorkshire (worst)

14%

62

444

*** Survival three times higher when cancer is diagnosed early

Cancer Research UK’s Spot Cancer Sooner Campaign will be launched on Monday 2 November: www.cruk.org/spotcancersooner