Up to a decade of progress on cancer at risk as a result of the pandemic, says think tank
The government must use the opportunity of restarting cancer services in the NHS to ‘build back better’.
New analysis by IPPR and the CF healthcare consultancy finds that survival rates for cancer could be set to drop significantly this year as a result of Covid-19.
Their modelling shows that five-year survival rates could drop from 16.2 per cent to 15.4 per cent for lung cancer, from 85 per cent to 83.5 per cent for breast cancer, and from 58.4 per cent to 56.1 per cent for colorectal cancer.
These declines would represent a significant setback to progress, with outcomes equivalent to those one year, six years, and eight years earlier respectively.
Depending on the level of disruption in other countries they could also leave the UK further behind in international performance tables. The survival rates implied by the modelling are equivalent to countries such as Turkey and Lithuania prior to the pandemic.
The study suggests the main cause of this decline will be late diagnosis and treatment of cancer caused by the pivot in the NHS towards prioritising Covid-19 patients. It highlights that during the pandemic:
- Screening across the UK has stopped during the lockdown meaning 210,000 people per week going without;
- Urgent GP referrals for diagnostics - formally known as the two-week wait - are down by over 40 per cent;
- Diagnostic testing, including through CT and MRI scans and endoscopy, is down by between 28 and 76 per cent;
- Treatment including surgery, chemotherapy and radiotherapy is down by between 10 and 40 per cent.
The report recognises recent initiatives by the government to restore performance across cancer services but argues that it must go “further and faster” by:
- Making diagnosis and treatment of cancer “Covid-safe’ by moving diagnostics into the community where possible and ensuring all cancer staff and patients are tested regularly. The analysis suggests this commitment alone would require up to 170,000 tests per week.
- Increasing capacity - particularly for diagnostics and treatment - as quickly as possible. The government must swiftly invest in more capacity to clear the backlog of patients - even if this means using the private sector.
It also argues that there is an opportunity to “build back better”, using the pandemic as an opportunity to address existing weaknesses in our health and care services for cancer by:
- Building on the prime minister’s recent obesity drive by launching a comprehensive new public health strategy to prevent illness. This should span the main causes of cancer, such as alcohol consumption and smoking, across both adults and children. It should also include restoring the public health grant by providing at least an additional £1bn per year.
- Increasing diagnostic and treatment capacity within the NHS by committing to match OECD levels of CT and MRI machines. The report also highlights the need for more endoscopy and radiotherapy equipment. This would require the government to match OECD levels of capital spending, as recommended by IPPR previously.
Harry Quilter-Pinner, IPPR associate director and head of its Better Health and Care Programme, said:
“The pandemic has been devastating, not just for families directly impacted by Covid-19 but also for those with loved ones suffering from other heath conditions. Our analysis shows that thousands could die early of conditions such as cancer as a result of the lockdown in NHS services. The government must make it a top priority to restart cancer services and ensure they are resilient for a potential second wave of Covid-19.
“But we do not have to - and should not - revert to the pre-Covid status quo which saw the UK lagging behind other advanced countries in cancer outcomes. We can use the disruption of the pandemic to design a better system. This demands bolder action on public health to prevent people from getting cancer, and also more investment in NHS diagnostics to ensure that if people do get cancer, we can catch it early.”
Harry Quilter-Pinner, the lead author and head of IPPR’s Better Health and Care programme, is available for interview.
Robin Harvey, Digital and Media Officer: [email protected]
NOTES TO EDITORS
1. The IPPR long-read article, The Hidden Cost of Covid-19 on the NHS - and how to ‘build back better’ by Harry Quilter-Pinner, will be published at 0001 on Sunday August 16. It will be available at: www.ippr.org/blog/the-hidden-cost-of-covid-19-on-the-nhs
2. The analysis contained in the article was undertaken in partnership with CF Healthcare Consulting. CF is publishing an extending briefing paper on this analysis here: https://www.carnallfarrar.com/life-sciences/life-sciences-insights/disruption-and-recovery-of-cancer-from-covid-19/
3. CF Healthcare consulting methodology: The most common route to diagnosing cancer is through ‘two-week-wait’ and GP referrals which accounts for around two-thirds of cancer diagnoses. As such, we have modelled the impact of the 43 per cent decrease in urgent referrals on stage of diagnosis, assuming a three-month disruption to cancer services, and that patients who are not diagnosed on time will be detected one stage later. If this comes to pass, many patients stand to be diagnosed at a later stage than they should have, resulting in a stage shift in diagnosis. Therefore, we modelled what this ‘new stage distribution’ would look like and how it could affect one-year cancer survival, including the excess deaths to come out of it compared to a normal stage distribution. We also looked at the effects on five-year survival and compared these new rates historically within England, and internationally to other OECD countries prior to the pandemic.
4. IPPR is the UK’s pre-eminent progressive think tank. With more than 40 staff in offices in London, Manchester, Newcastle and Edinburgh, IPPR is Britain’s only national think tank with a truly national presence. www.ippr.org