{"id":26361,"date":"2020-09-11T12:32:04","date_gmt":"2020-09-11T12:32:04","guid":{"rendered":"https:\/\/scienceblog.cancerresearchuk.org\/?p=17944"},"modified":"2024-11-03T15:16:18","modified_gmt":"2024-11-03T15:16:18","slug":"whats-happened-to-cancer-services-during-the-covid-19-pandemic","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/whats-happened-to-cancer-services-during-the-covid-19-pandemic\/","title":{"rendered":"What\u2019s happened to cancer services during the COVID-19 pandemic?"},"content":{"rendered":"
\"Cancer<\/p>\n

Victoria worked at the The Christie NHS Foundation Trust in Manchester during the pandemic.<\/p>\n<\/div>\n

It\u2019s been 6 months since the UK entered lockdown.<\/p>\n

And with life slowly opening back up, at least for now, the events of March can sometimes seem distant and otherworldly. But the effects of the COVID-19 pandemic, and the devastating impact it\u2019s had on cancer services, remain.<\/p>\n

We\u2019ve covered some of COVID-19\u2019s consequences<\/a> before. But for the first few months all we had were snapshots and relative estimates. Six months on, we\u2019ve got a much clearer picture how cancer services were affected, and how well they\u2019re recovering.<\/p>\n

Here\u2019s what we know.<\/p>\n

Screening<\/h2>\n

Let\u2019s start with screening, which was badly affected by the COVID-19 pandemic, with bowel, breast and cervical screening programmes all put on hold at the beginning of lockdown.<\/p>\n

And with around 210,000 people being screened each week in the UK before the pandemic, the backlog of people waiting for screening has stacked up quickly \u2013 we put the figure at around 3 million so far.<\/p>\n

The good news is that some programmes have now restarted in some way. But given the number of people needing to be screened, it may be some time before they are back on track. And as health is a responsibility for each Government across the UK, timelines for restarting will be slightly different in each UK nation.<\/p>\n

Getting screening up and running and addressing the backlog poses significant and unique challenges for each programme. For cervical screening, services are prioritising people who had an abnormal screening result before lockdown, followed by people who had an abnormal result the year before and then those who didn\u2019t receive a screening invite during the pandemic.<\/p>\n

While breast screening is restarting, capacity is lower due to infection control requirements and the additional cleaning that needs to take place. There\u2019s also work to be done to ensure that mobile breast screening units, which are particularly important in more remote areas of the UK, can deliver breast screening safely.<\/p>\n

Finally, bowel screening. The main area of concern for this programme is not the screening test itself, because it\u2019s a test people do at home, but the follow-up test: colonoscopy<\/a>. Colonoscopy is a type of endoscopy<\/a>, which uses a camera to look inside the body.<\/p>\n

With endoscopy services among the worst hit, clearing the backlog of people waiting for a bowel screening follow up test is not easy. And it\u2019s been made more challenging as the backlog of those referred by their GP for an endoscopy grows too.<\/p>\n

But while it\u2019s vital to get invites out, getting screening back on track will depend on people taking up their invite. We\u2019ll be monitoring uptake closely over the next few months, as well as looking to see if the pandemic has changed who takes part in screening.<\/p>\n

Cancer diagnosis<\/h2>\n

Another area that was heavily affected by COVID-19 was the number of people being urgently referred with suspected cancer symptoms. Between April and August, we\u2019ve estimated that around 350,000 fewer people were referred than normal in the UK.<\/p>\n

This drop is largely because fewer people went to their GP with symptoms that might be cancer, but we also know that some GPs were reluctant to risk sending people to hospitals during the height of the pandemic. The good news is the figures are steadily improving, but they\u2019re still slightly lower than before lockdown.<\/p>\n

\"Graph<\/p>\n

Copy this link and share our graphic<\/a>. Credit: Cancer REsearch UK<\/span><\/p>\n<\/div>\n

But with 350,000 fewer people being referred since lockdown began lockdown, getting back to \u2018normal\u2019 isn\u2019t enough. We need to see the number of referrals rise above pre-COVID figures to address the backlog of people who didn\u2019t go to their GP or weren\u2019t referred during lockdown and who still have concerns or symptoms.<\/p>\n

Urgent suspected cancer referrals are only one part of the picture, with normally around a third of people with cancer being diagnosed through this route. But they\u2019re a good indication of how many people are coming forward with symptoms and cancer services are doing across the UK , alongside other figures.<\/p>\n

Because for cancer services to fully recover, we also need the people being referred to get the tests they need in a timely manner.<\/p>\n

Which brings us to diagnostic tests. Most of the figures we have cover all diagnostic test activity and aren\u2019t specific to cancer. But we can see that the number of tests that are often used to diagnose cancer \u2013 endoscopies (colonoscopy, flexi-sigmoidoscopy<\/a>, cystoscopy<\/a> and gastroscopy<\/a>), CT scans<\/a>, ultrasound<\/a> and MRI<\/a> \u2013 all dropped at the start of lockdown.<\/p>\n

In England, there was a 39% drop in the number of these 7 key diagnostic tests between March and July this year, which is equivalent to around 3.2 million fewer tests compared to the same period last year. The figures have started to recover since they hit their lowest point April, as you can see from the endoscopy figures below, but we\u2019re still not back to last year\u2019s activity.<\/p>\n

<\/p>\n

Copy this link and share our graphic<\/a>. Credit: Cancer Research UK<\/span><\/p>\n<\/div>\n

And this drop in activity, combined with the additional safety measures put in place during the pandemic, has had a knock on effect on how long people are waiting for tests.<\/p>\n

In England, the number of patients waiting 6 weeks or more for a diagnostic test has risen significantly since April, with the biggest increase in May . And while the number of patients waiting 6 or more weeks has fallen slightly in July, there are still 12 times more patients waiting 6 weeks or more for one of the 7 key diagnostic tests compared to the same time last year.<\/p>\n

\"Graphic<\/p>\n

Endoscopy waiting lists at the end of each month in England. Copy this link and share our graphic<\/a>. Credit: Cancer Research UK<\/span><\/p>\n<\/div>\n

Data released for Scotland and Northern Ireland shows a similar picture.<\/p>\n

Cancer treatment<\/h2>\n

We\u2019ve got less data when it comes to the impact of COVID-19 on cancer treatment. But since lockdown we know there\u2019s been a decrease in the number of people beginning treatment since April 2020, with a 37% drop in the number of patients beginning treatment in England in May compared with the same period last year.<\/p>\n

\"Graph<\/p>\n

Copy this link and share our graphic<\/a>. Credit: Cancer Research UK<\/span><\/p>\n<\/div>\n

The spike in March corresponds to the period just before lockdown in England, when clinicians were trying to get as many people as possible through treatment before the pandemic really hit. Sometimes these March figures are grouped together with April and May and quoted as a lockdown figure.<\/p>\n

For example, one figure used in the media is that over 65,000 people started cancer treatment from March to May \u2013 85% of the number that started in the same period last year. But this can be slightly misleading, as the spike in March masks the subsequent drop.<\/p>\n

And the real impact of COVID-19 on cancer treatment overall may be masked by the fact that some people, including those who started treatment before the pandemic, have had changes to their treatment \u2013 radiotherapy before or instead of surgery for example. This has been done for good reasons, but the long-term impact on patient outcomes is hard to predict, especially since we don\u2019t yet have good data on how many people have had their treatment switched in this way.<\/p>\n

In a survey we conducted in May, 1 in 3 cancer patients said their treatment had been impacted by the effects of COVID-19 on the health system. And 4 in 10 people said their tests \u2013 including those to find out whether their cancer has spread or returned \u2013 had been affected.<\/p>\n

These delays had a big impact on people\u2019s mental health, with around 7 in 10 people who experienced delays feeling more frustrated and anxious.<\/p>\n

The good news is there are definite signs that cancer treatment is beginning to recover, with the number of patients beginning treatment rising in June and July, although it\u2019s still around 24% lower than the same time last year.<\/p>\n

Looking to the next few months, one challenge for the NHS will be ensuring it has enough capacity to treat the backlog of patients who receive their diagnosis as diagnostic services recover.<\/p>\n

Building better cancer services<\/h2>\n

The last 6 months has been one of the most challenging period in the history of the NHS. And thanks to the dedication of healthcare staff and the work of cancer recovery planners in all 4 UK nations, the figures are moving in the right direction.<\/p>\n

But there\u2019s a lot of work that still needs to be done to get cancer services back on track and to ensure that cancer screening, diagnosis and treatment will not be as severely impacted by any future waves of COVID-19.<\/p>\n

We\u2019ve written before<\/a> about what needs to happen to make sure that everyone gets the care they need, when they need it. But it\u2019s not just about getting back on track, we need to aim higher. Cancer services weren\u2019t functioning perfectly before the pandemic, with survival for many cancer types lagging behind comparable countries<\/a>.<\/p>\n

Now is the time to not only rebuild our cancer services, but to make them world-class. To make sure that everyone with cancer gets the diagnosis, treatment and care they deserve. And central to this transformation is a strong cancer workforce.<\/p>\n

In a few month\u2019 time the Government will decide how much money will be available to invest in recruiting and training more staff to help diagnose and treat cancer.<\/p>\n

><\/span> Ask your MP to stand shoulder to shoulder with our NHS today<\/a><\/strong><\/p>\n

Katie<\/em><\/p>\n

More on this topic<\/h3>\n<\/p>\n

Source<\/a><\/p>","protected":false},"excerpt":{"rendered":"

Victoria worked at the The Christie NHS Foundation Trust in Manchester during the pandemic. It\u2019s been 6 months since the UK entered lockdown. And with life slowly opening back up, at least for now, the events of March can sometimes seem distant and otherworldly. But the effects of the COVID-19 pandemic, and the devastating impact […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[5137],"tags":[],"class_list":["post-26361","post","type-post","status-publish","format-standard","hentry","category-world-news"],"_links":{"self":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/26361","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/comments?post=26361"}],"version-history":[{"count":1,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/26361\/revisions"}],"predecessor-version":[{"id":44162,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/26361\/revisions\/44162"}],"wp:attachment":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/media?parent=26361"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/categories?post=26361"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/tags?post=26361"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}