In September of this year, I wrote about how the growing staffing crisis in histopathology is impacting on the diagnosis and treatment of cancer in the NHS, click here to read more.
This week, the Health Foundation published its review of 20 years of cancer detection and treatment in the NHS, click here to read the review . The review, Unfinished Business, states that whilst progress has been made in the diagnosis and treatment of cancer and that survival rates have improved significantly, the UK is still lagging behind many countries including Australia, Sweden and Canada.
Improvements have been made largely owing to greater investment in staff and new technology together with the development of a multi-disciplinary team approach to cancer care. However, despite this, 5 year survival rates have not caught up with those of comparable countries in respect of the most common cancers such as breast, colon, lung and ovarian cancer.
What can be done to improve this? The review identifies that early diagnosis is key and that rates have to improve; they have been static for the past 2 years. The Government has announced that a new cancer strategy will be part of the long-term plan for the NHS with the intention that by 2028, three in four cancer patients should be diagnosed at an early stage. This means that improvements will need to be made in primary care and how and when GPs refer patients with suspected cancer for further investigation. It is recommended that NICE Guideline 12, which states that GPs should refer patients for further investigation if they have symptoms suggestive of a risk of cancer of 3% or more, is properly implemented and that GPs are made fully aware of it.
In addition, patients should ensure that they take up routine screening such as bowel screening and see their GP at an early stage if they are concerned about their symptoms. The report considers that patients often worry about bothering their GP with symptoms they think might turn out to be nothing. Better education is therefore needed on the early signs and symptoms of at least the most common cancers.
A greater number of early referrals will of course impact on hospital care in an already overwhelmed system. With staff shortages in cancer care and across the NHS generally, cancer waiting times at their worst ever and the closure of cancer treatment centres meaning that patients are having to travel long distances to access care, it is difficult to see how significant change can be effected in the near future. Much more funding will be needed to plug the gaps which already exist and to start to facilitate improvement.
Crucially, the review considers that if the recommended changes are made, 10,000 lives could be saved each year. As recent research shows that 1 in 2 people will be diagnosed with cancer in their lifetime, it is imperative for cancer patients present and future that these targets are achieved. However, it is clear that this will not happen without major investment.