Cancer diagnosis in lockdown cut six months off survival
Study shows worrying drop in life expectancy
CANCER patients who were diagnosed during lockdown had shorter survival times than those whose illness was caught earlier, an alarming study has revealed.
People whose stomach or oesophageal cancer was detected during Scotland’s first Covid wave survived six months less than usual.
Their tumours were more likely to have been spotted at an emergency hospital admission than by a clinic referral and their cancer was more likely to have spread.
The Glasgow research is the first of its kind to look at the outcomes of patients diagnosed with cancer when NHS services were put on hold.
Although limited to stomach and oesophagus cancers, experts say other types are likely to have been affected.
Routine health services were suspended in March 2020 to make way for Covid cases and halt the spread of the virus.
While urgent cancer services continued, there have been concerns over the impact of GP appointment curbs and patients being told to stay away from the NHS unless their condition was critical.
In order to measure this, the research was carried out by cancer surgeons at Glasgow Royal Infirmary and the Institute of Cancer Sciences at Glasgow University.
The team looked at 349 patients diagnosed with oesophagogastric (OG) cancer between October 2019 and September 2020.
Lead researcher Khurram Khan, a surgeon specialising in upper gastrointestinal surgery, said: ‘OG cancer is often at an advanced stage at diagnosis. However, early detection and timely treatment can influence overall survival.’
He added: ‘The strict UK Government stay-at-home message combined with a degree of national public fear is thought to have contributed to the fall in presentation of new cancer cases combined with changes to general practice service delivery, reduced access to secondary specialist care, limited face-to-face encounters, and reduced availability of endoscopy.’
The researchers found acute hospital admissions for cases of OG cancer rose from 12.5 per cent before the pandemic to 28 per cent in the first wave. This indicates that more patients ended up in hospital with their symptoms rather than being referred through the urgent cancer system.
Patients referred for tests by their GP waited almost twice as long during the first wave than before the pandemic – an average of 28 days compared to 15 days.
The proportion of cases where the cancer had already spread at the time of first diagnosis rose from 33.3 per cent to 47.8 per cent.
Overall survival was six months less after lockdown at seven months, compared to 13 months, the study – published in the British Journal of Surgery – found.
Dr Khan said that it was ‘of concern’ that OG cancer numbers for 2021 have not yet caught up with 2019 levels – so there could be more Scots with cancer that has not yet been diagnosed.
Eva Morris, professor of health data epidemiology at Oxford University, said: ‘This could affect cancers with vague symptoms such as lung cancer, bowel cancer and blood cancer.’
Scottish Tory health spokesman Dr Sandesh Gulhane said: ‘This highlights the devastating impact the pandemic has had for cancer patients.
‘We are still facing a ticking time bomb when it comes to diagnosing cancer patients early enough and tragically, for some patients, it will have been too late.’
A Scottish Government spokesman said yesterday: ‘Diagnosing and treating cancer has continued to be a key clinical priority throughout the pandemic.
‘Early cancer diagnosis has never been more important which is why we’ve committed a further £20million to our Detect Cancer Early Programme over the parliamentary term.’
‘Often at an advanced stage’ ‘Facing ticking time bomb’
THE toll of lockdown is growing more evident and more appalling.
A new study finds that cancer patients diagnosed while the country was in quarantine died six months earlier than those diagnosed prior to Covid-19.
This was the case with patients suffering stomach and oesophageal cancer. Reduced access to GPs may have contributed.
It is not good enough to blame the pandemic. Covid set us back. But the SNP Government was missing its cancer targets long before and is still missing them now.
The 62-day treatment target has gone unmet eight years running; in the past year, more than 3,000 cancer patients waited longer to be treated.
This is more than a challenge to clinical practices. More than a problem of resources and staffing. this is a moral test.
It presents a fundamental question: after the progress made towards making some cancers survivable and others more liveable, are we content to go backwards?
The scottish Government has spoken about remobilising the NHs. Evidence is thin on the ground so far. this crisis is not insurmountable. Backlogs can be cut, waiting times reduced, services expanded.
Doing so would not be easy but it would be expedited by the full energies and undistracted focus of government ministers. Instead, their attention is on what it is always on: independence.
The SNP’s constitutional fixations are frustrating at the best of times but unforgivable in times like these. there should be no higher priority for any government than tending to the health and wellbeing of its citizens.
What a sad empty existence it must be to care more – to care only – about constitutional abstractions.
Nicola sturgeon and her government must get back to running the country.
Not only because scotland already said No to independence. Not only because the constitution is reserved. But because scotland faces many more pressing problems right now.
Reversing this troubling cancer trend is just one of them. Yet it is imperative. scotland needs a government, not a 24/7 grievance machine. It is a matter of priorities. It is a matter of life and death.