A recent report found the pandemic has set back cancer survival rates, which were already in dire straits due to a pervasive reluctance to come forward. Now a new study paints an even bleaker picture: the UK surpasses all other comparable high-income countries in patients diagnosed with cancer in an emergency.
The findings are of grave concern because people who end up in A&E, sometimes after repeated trips to their GP, are less likely to survive their disease, particularly if they have stomach, bowel, liver, pancreatic, lung or ovarian cancer.
The new study, from the International Cancer Benchmarking Partnership (ICBP), working with Cancer Research UK, looked at cancer data and linked hospital admissions from 14 areas in six countries: Australia, Canada, Denmark, New Zealand, Norway, and the UK, covering 2012 to 2017.
In Northern Ireland, which was measured using a different definition, emergency diagnoses were more than a quarter (28 percent).
From 857,068 cancer patients in all the country regions, the percentage of diagnoses through emergency presentation ranged from 24 percent to 43 percent.
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When it came to individual cancers, 46 percent of people with pancreatic cancer were diagnosed in an emergency overall, but the figure was much higher, at 56 percent, in England and Wales, and 59 percent in Scotland.
Meanwhile, New Zealand had 60 percent of patients diagnosed as an emergency with pancreatic cancer and Norway had 55 percent, but Ontario in Canada had just 35 percent and Alberta had 41 percent.
Some 34 percent of people in England and Wales and 35 percent in Scotland were diagnosed with bowel cancer in an emergency, but the figure was 27 percent in Ontario and 32 percent in New South Wales in Australia.
Meanwhile, 47 percent of people in the UK were diagnosed with liver cancer in an emergency, compared to 40 percent in New South Wales, 32 percent in Alberta and 28 percent in Ontario. In Norway the figure was 51 percent.
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The study found that those aged 75 and over were more likely to be diagnosed in an emergency, as were those whose cancer was advanced.
Emergency diagnoses also resulted in a two-fold higher risk of dying in the next 12 months compared to people being diagnosed at other times.
For bowel, stomach, lung, liver, pancreatic and ovarian cancer, a 10 percent increase in the percentage of emergency admissions in a region was linked to a drop in one-year survival of three to seven percent.
Cancers that often had non-specific, vague symptoms, such as pancreatic, liver, lung, and ovarian cancer, were also more likely to be diagnosed in A&E.
Although the report did not specify the symptoms, a testimonial from Matthew Black, a 57-year-old chartered surveyor and father of two, provides an insight into the kind of symptoms people are presenting with in A&E.
Mr Black started having stomach problems and losing weight in April 2020, but his bowel cancer symptoms were thought to be after-effects of Covid. He was diagnosed in A&E.
Mr Black, who was given the all clear, said: “It’s too bad my cancer wasn’t caught earlier, but I consider myself extremely lucky.
“It’s important people do not ignore sudden or unusual changes to their bodies.
“And don’t leave it too long to get back in touch with the GP practice if symptoms don’t go away or get worse. It could save your life.”
Commenting on the findings, Michelle Mitchell, Cancer Research UK’s chief executive, said: “For months we have been warning that cancer survival could go backwards due to the pandemic.
“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.
“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.
“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 percent of cancer cases are diagnosed through emergency routes.”
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