Michelle Mitchell emphasises on adoptive commitments for tackling cancer inequalities, clearing backlog of diagnostic waits and stopping cancer survival from going backwards

It’s been almost a year since the UK locked down. Overnight, doors were shut – to homes, offices and shops - while key workers battled on the frontlines and our health service faced the largest challenge in its history. 

Ever since, the race has been on to get cancer and other services back up to capacity. And rightly so – there’s a backlog of tens of thousands of people waiting for a diagnosis, tests or treatment. But it would be short-sighted of the government and the NHS to simply aim for a return to how things were before.

Inequality in health systems

Before the pandemic hit, UK cancer survival was improving but there were worrying signs of pressure. January 2020 was the worst 62-day cancer waiting times on record in England. Staff shortages meant pressure was mounting, with too many vacant positions in the diagnostic workforce. Profound inequalities meant there were thousands of extra cancer cases in more deprived areas, and cancer survival in the UK still lagged behind other high-income countries.

And then the pandemic hit, with a devastating impact on cancer services. 41,000 fewer patients in the UK started treatment in 2020 compared to the year before. And we’re very concerned by the low numbers of people diagnosed with lung cancer – whose symptoms resemble covid-19. The pandemic also exposed inequality in the world’s health systems like never before.

The government has committed to improving cancer survival. But these words have not yet been backed up by the right plan and the right level of funding.

And because of underinvestment, cancer services in the UK entered the pandemic in a weaker position than other countries. And because so far we’ve been hit harder by covid-19, it will be even more challenging to catch up. For example, countries like Australia were largely able to continue cancer screening programmes, while the UK saw 3 million fewer people screened for cancer between March and September.

But there’s lots to learn from international comparisons. Research suggests countries that invest in staff, infrastructure and equipment for diagnosis and treatment - particularly in surgery - have better quality of care for cancer patients. We could learn from that.

But despite everything, there’s a lot to be proud of.

Throughout the pandemic, doctors, nurses, staff and the health system have achieved the herculean task of protecting us all, to adapting to the hand they’d been dealt and continuing cancer care wherever possible.

Services were reconfigured to become covid-secure; collaboration was championed regionally, and links made with the private sector. The health system adopted new technologies and therapies to make sure patients got seen and treated as safely as possible. This innovation is vital to the future of the health service.

We must now look to our next challenge: clearing the backlog of patients who should have been diagnosed and started treatment

Michelle Mitchell

Today, services are almost back to pre-pandemic levels – but fewer people are in the system. Having listened to the message to “stay at home”, fewer people have come forward with worrying symptoms.

We must now look to our next challenge: clearing the backlog of patients who should have been diagnosed and started treatment.

What the future looks like?

But what does the UK’s future cancer care look like? We predict that by 2035 as the average age of the UK population increases, half a million people will be diagnosed with cancer every year. And pressures on the health service will only get worse. 

Next week’s Spring budget is an opportunity for the government to demonstrate that cancer is a priority. We want to see a plan and timeline for clearing this backlog, a multi-year investment to grow the cancer workforce and a commitment to spend the billions needed to refresh and expand diagnostic equipment.

These commitments would support the recovery of cancer services, but won’t be enough to bring UK cancer survival in line with comparable countries. We need to see real transformation – tackling cancer inequalities and putting research and innovation at the heart of cancer services.

The consequence of inaction is serious: a real possibility that for the first time in decades, cancer survival could go backwards.