Over a third of cancers are only diagnosed after going to A&E

Over a THIRD of cancer patients are only diagnosed after going to A&E or getting an emergency referral and numbers may have risen during the pandemic, study warns

• More cancers diagnosed in A&E in England than Denmark, Australia and Canada 
• Cancers found in A&E have usually been allowed to develop for longer 
• 32.3% of cancer patients were diagnosed in A&E in England from 2012 to 2017

More than a third of cancer patients in England are only diagnosed with the disease through the emergency route, a study revealed today. 

University College London academics found the nation was lagging behind Norway, Denmark, Australia and Canada.

Charities today called for action to ensure fewer patients are being diagnosed with cancer after an emergency referral or trip to A&E. 

Cancer Research UK fears the outlook will now be even worse following Covid. The pandemic had a devastating impact on NHS cancer services, with crucial treatment disrupted and tens of thousands fewer people coming forward for checks. 

Survival rates are lower for cancers spotted through the emergency route because they have usually been allowed to develop for longer, causing symptoms that need medical attention. 

The findings come after MPs warned Britain’s cancer survival rates could be set to reverse because of a lack of ‘serious effort’ to deal with the NHS workforce crisis.

The Health and Social Care Committee claimed staffing shortfall are ‘jeopardising’ progress on diagnosing cancer early.

More than a third of English patients are only diagnosed with cancer after going to A&E. More cancers were diagnosed in emergency departments in the England than in Norway, Denmark, Australia and Canada

Pancreatic and liver cancers were more likely to be diagnosed in A&E  in England from 2012 to 2017 than other forms

NHS cancer diagnosis and treatment targets have spiralled to record lows in the vast majority of metrics and with one exception, which has no target, all are below the health service’s operation standard

A father-of two was diagnosed with colon cancer in A&E after his GP thought he was suffering from the after-effects of Covid.

Matthew Black, a 57-year-old chartered surveyor from London, started having stomach problems and losing weight in April 2020, so he got in touch with his GP.

Initially it was thought that this could be the after-effects of an asymptomatic Covid infection, but after dropping 30lb (14kg) in just one month, Matthew’s family encouraged him to go to A&E.

Scans revealed a blockage in his colon and he underwent a five-hour surgery to remove the grapefruit-sized tumour that was obstructing his bowels.

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.’

Academics at the International Cancer Benchmarking Partnership (ICBP), alongside Cancer Research UK, carried out the analysis.

The study, published in The Lancet Oncology, reviewed diagnoses methods of eight major cancers from 850,000 patients.

Participants came from 14 areas across six countries: Australia, Canada, Denmark, New Zealand, Norway and the UK.

Overall, the percentage of diagnoses through emergency presentation ranged from 24 per cent to 43 per cent.

More than a third of patients in England, Wales (both 37 per cent) and Scotland (39 per cent) were diagnosed after being rushed to hospital. 

In Northern Ireland, which was measured using a different definition, the figure was closer to a quarter (28 per cent).

England’s proportion was slightly more than Norway (65.5 per cent), Denmark (30.9 per cent), Australia (28 per cent) and Canada (27.4 per cent).  

When it came to individual cancers, 46 per cent of people with pancreatic cancer were diagnosed in an emergency overall.

But the figure was much higher, at 56 per cent, in England and Wales, and was 59 per cent in Scotland.

Meanwhile, New Zealand had 60 per cent of patients diagnosed as an emergency with pancreatic cancer and Norway had 55 per cent, but Ontario in Canada had just 35 per cent and Alberta had 41 per cent. 

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.  

Professor Georgios Lyratzopoulos, lead researcher from University College London, said: ‘The data tell us that emergency presentations are a global problem — and not concentrated in a single country or health system.

‘Getting better at preventing cancer, detecting it through screening, or diagnosing it soon after symptoms appear can help decrease emergency presentations and reduce cancer deaths.’

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.’

 The performance of the NHS’s current cancer referral targets have declined in the past decade with the number of cancer patients who received urgent treatment within two months falling to 67 per cent last year, the target is 85 per cent 

The charity wants to see fewer than 10 per cent of cancer cases diagnosed through emergency routes by 2032.  

Despite NHS efforts to protect cancer services during Covid, millions missed out on screening and diagnostic tests. 

Meanwhile, cancer diagnosis and treatment times in England have reached all-time lows.

Sajid Javid last month declared a ‘war on cancer’, in an attempt to boost survival rates.  

He will later this year unveil a plan that aims to diagnose tumours earlier when they are easier to treat. 

The Government aims to diagnose 75 per cent of all cancers at stage one or two by 2028. 

Up to 90 per cent of people diagnosed with stage one lung cancer survive for at least five years, compared to just a quarter of those with stage four. 

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