Over the past 18 months the focus of everyone has been on the Covid 19 pandemic. Whilst this is obviously understandable, research suggests that it has had a catastrophic impact on cancer services in the NHS.

At the start of the pandemic cancer screening was badly affected with bowel, breast and cervical screening programmes largely put on hold. Also, the number of people being urgently referred with suspected cancer symptoms by their GP drastically dropped.

In December 2021, Public Health England published data for the first year of the pandemic (April 2020 to March 2021) which showed that over 39,000 fewer patients were diagnosed with cancer compared to the previous year. There were also 300,000 fewer two-week wait cancer referrals.

The National Audit Office report published in December 2021 reviewed the impact of the pandemic until September 2021 and estimated that the drop in two-week wait cancer referrals had risen to 740,000 over the course of the pandemic with up to 60,000 patients with cancer entirely missed by the system.

Importance of early cancer referrals

The two-week wait referral system was introduced to try to avoid delays in diagnosis of cancer in patients who were presenting to their GPs with symptoms that could be suggestive of cancer, for example blood in the stools for bowel cancer or a change in size, shape or colour of a mole may indicate skin cancer and to get them seen by a specialist as quickly as possible. This is because it is known that an early diagnosis and earlier access to treatment is shown to improve the chances of survival. Also early investigation provides faster reassurance to those patients that do not have cancer.

Having acted for too many cancer patients or their bereaved relatives I have seen first-hand the devastating impact of those important early referrals not being made. Just before the start of the pandemic I settled a very sad case for a lady whose husband died of bowel cancer as a result of not being referred for cancer investigations early enough despite attending his GP on almost a weekly basis for five months with changed bowel habit. Our case, which was supported by independent expert evidence from a colorectal surgeon and oncologist, was that had her husband been referred to hospital as he should have been three months earlier, he would have survived.

This case brought home to me just how important the two-week referral process is and when I read the above statistics (300,000 less referrals in 18 months) I worry about the impact of those lost referrals on those patients and their families. According to Cancer Research UK each week a cancer diagnosis is delayed, the risk of death increases by up to 3.2 per cent. For more information, please read our Bowel Cancer Signs, Symptoms and Treatment resource.

Cancer treatment also delayed

The pandemic has also had a devasting impact on existing cancer patients who were awaiting or undergoing treatment. Cancer Research UK's July 2021 patient survey found that almost a third of cancer patients experienced delays, cancellations or changes to treatment this year.

In many previous cases I have discussed with our medical experts the effect of any delay in cancer patients receiving treatment. Not only does it prolong the anxiety for the patients and their families but it can also have an impact on the treatment options available.

Cancer Research UK also found that the pandemic had an unequal impact on different patient groups according to the type of cancer, with the number of people diagnosed with prostate, lung and bowel cancer particularly impacted.

More must be done now to ensure that we do not enter a ‘cancer crisis’ and that cancer patients are not forgotten whilst so much attention is focussed on Covid. To achieve this it seems further investment and a system that ensures cancer patients, as well as those with Covid, can be seen and treated is needed to ensure that diagnostics and treatment are more readily available. This will improve patient safety and give individuals the best chance of avoiding or being treated for this devastating disease.