Delays in cancer diagnosis 'claim thousands of lives each year'
Wednesday 2 December 2009
Earlier diagnosis of people with cancer could save between 5,000 and 10,000 lives each year, Professor Mike Richards, the National Cancer Director for England, has claimed.
Professor Richards has written an article for a special supplement of the British Journal of Cancer, which estimates the extent to which delayed diagnosis influences survival rates in England.
This analysis included data on late diagnosis and rates of surgery, radiotherapy and chemotherapy for breast, bowel and lung cancer - the three cancers with the highest UK death rates - in the late 1990s in England and other European countries.
The analysis indicates that late diagnosis was almost certainly a major contributor to poor survival in England for all three cancers.
The study revealed that between 5,000 and 10,000 deaths within five years of diagnosis could be avoided every year in England if efforts to promote earlier diagnosis and appropriate primary surgical treatment are successful.
Although exact estimates are impossible, it seems highly likely that these factors accounted for the large majority of the avoidable deaths in England observed during the 1990s for patients with breast, bowel and lung cancer.
There is no reason to think that the same factors will not apply in some, if not all, other cancers for which survival in England is below the European average.
The article noted that things are likely to have changed over the ten years since the data were collected, with major progress being made in terms of cutting hospital waiting times, extending and improving the national breast screening programme and introducing bowel screening.
However, it is pointed out that much less attention has been paid to the problem of late diagnosis, which is starting to be addressed through the National Awareness and Early Diagnosis Initiative (NAEDI).
NAEDI is a public sector/third sector partnership that was announced in the Cancer Reform Strategy. Led by Professor Richards and Harpal Kumar, Cancer Research UK's chief executive, its role is to coordinate and provide support to activities that promote the earlier diagnosis of cancer.
Professor Mike Richards, National Cancer Director and author of the paper, said: "These delays in patients presenting with symptoms and cancer being diagnosed at a late stage inevitably cost lives. The situation is unacceptable so the first big step has been to understand why the delays occur.
"The next step for the National Awareness and Early Diagnosis Initiative (NAEDI) is to fix this problem. To do that we're working with people at a community level and with GPs to help them identify patients who could have cancer. On a wider scale, the government is committed to improving GPs' access to diagnostic tests.
"Cancer Research UK researchers also published a national survey for NAEDI, which revealed that 40 per cent of us would put off going to our doctor because we're worried about wasting their time. We now need to investigate the best ways to break down any barriers between GPs and patients and how to reduce delays in primary care.
"Early diagnosis is our next big challenge in cancer and will be crucial in bringing our survival rates up to the best in Europe."
Sara Hiom, director of health information at Cancer Research UK, said: "It's really important that people can recognise cancer symptoms and feel that they can report concerns to their GP at an early stage.
"When cancers are detected earlier, treatment is usually more effective and often milder. We're not expecting people to be able to recall every symptom, but being generally aware of changes that could be a sign of cancer could make a crucial difference for people who do develop the disease."
Ms Hiom noted that GPs are faced with a difficult task, with the average family doctor only seeing one case of each of the four biggest cancers each year.
"Many of the symptoms that could be cancer often turn out to be something less serious, but it's best to get things like unusual lumps, changes to moles, unusual bleeding or changes to bowel motions checked out by a GP," she added.
- Richards, M. (2009). The size of the prize for earlier diagnosis of cancer in England British Journal of Cancer, 101 DOI: 10.1038/sj.bjc.6605402
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