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The Guardian - UK
The Guardian - UK
Politics
Denis Campbell Health policy editor

Cancer test and treatment delays in UK have put ‘100,000 lives at risk’ since 2014

A consultant analysing a mammogram.
A consultant analysing a mammogram. Photograph: Rui Vieira/PA

At least 100,000 people across the UK have had their lives put at risk over the last decade because of delays to them getting tested or treated for cancer, a new report claims.

In some cases, patients’ treatment options narrowed or their cancer spread or became incurable as a direct result of their long waits for NHS care, according to Macmillan Cancer Support.

The “inhumane” impact of delays on patients is “shameful”, it said, blaming ministers across the four home nations for underfunding and not tackling staff shortages in cancer services.

“I’ve had patients arrive for their radical chemotherapy appointment, who wait three hours only to be told that because of staff shortages we can’t deliver their treatment today. It’s inhumane”, said Naman Julka-Anderson, an advanced practice therapeutic radiographer who is also an allied health professional clinical adviser for Macmillan.

An analysis by the charity has found that about 180,000 more people than planned for in NHS cancer waiting time performance targets had to endure a long wait to be diagnosed or begin treatment between January 2014 and December 2022.

Many waited longer than 62 days to start treatment – surgery, chemotherapy or radiotherapy – after a GP referred them as an urgent case, the charity’s analysis of official NHS data found.

At least 100,000 of those 180,000 people have seen their symptoms worsen, or their cancer progress or their chances reduce of successfully being treated because they have had to wait, Macmillan said, citing a representative sample of more than 4,000 cancer patients it commissioned from pollsters YouGov.

“Cancer care is in crisis after years of governments failing to act,” said Gemma Peters, the charity’s chief executive.

“Every single person who has faced a worse outcome from their cancer diagnosis because of delays will know the devastating impact that waiting has had on their lives, from the burden of anxiety that their cancer is growing and for many the devastating news that their cancer is now incurable.”

Cancer waiting time performance has declined sharply in recent years as the NHS has struggled to test the rising numbers of people showing possible symptoms of the disease and treat those who were diagnosed with it within agreed waiting times.

Delays have become more common as cancer services have not expanded fast enough to meet the extra demand caused by the ageing and growing population and efforts by GPs to improve the UK’s poor record on early diagnosis by sending many more patients than before to be tested. Serious shortages of personnel, such as specialist nurses and radiologists, have hindered progress.

Waiting times for cancer care have declined in England for the last 10 years, and Macmillan pinpointed 2014 as the “tipping point when the health service in England could no longer keep up with the growing number of people who required cancer care.”

Wales recorded its worst ever cancer waiting times in January. In Scotland just 71% of patients are starting their treatment on time. And the situation is even worse in Northern Ireland where last year just 38.6% of people began treatment when they should have.

Shirley, a 56-year-old in Essex was who diagnosed with breast cancer in 2016, had to chase her oncology team to find out whether she needed to keep taking a course of tablets.

“From September I spent weeks hounding my oncologist’s secretary, leaving messages, trying to find out what was going on. I was left fighting, phoning every single week. I’d lie awake worrying the cancer had come back.

“I didn’t get an answer until January this year, when I received a letter to say that I was in fact discharged from oncology care. But it was decided that I’d be carrying on with the tablets for another five years from now.”

Angie, from York, who was also diagnosed with breast cancer in 2016, was urgently referred to gynaecological services in August 2022 when she developed complications but not seen until this March – seven months later.

“Hospitals are under extreme pressure and politicians need to do something. The anxiety of these waits intrudes into every aspect of your life. I couldn’t eat or sleep. Every time the post came I would rush to the door praying it was a follow-up letter from the hospital. It felt like somebody was playing Russian roulette with my life,” she said.

The Department of Health and Social Care did not respond directly to Macmillan’s findings. A spokesperson said: “Cutting waiting lists is one of this government’s five priorities and the NHS has seen and treated record numbers of cancer patients over the last two years, with cancer being diagnosed at an earlier stage more often and survival rates improving across almost all types of cancer.

“We have opened 108 community diagnostic centres that have delivered over 4m additional tests, checks and scans – including for cancer, which is also one of the six conditions we are looking to tackle as part of our major conditions strategy.”

They added that the NHS has “50% more cancer staff diagnosing and treating patients now compared with 2010”.

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