Chart of the week: The pathway to cancer diagnosis

Each week we present analysis of data in chart form to illustrate some key issues and invite discussion. With the pandemic having had a significant impact on cancer services, in this week’s chart Jenny Davies looks at how the numbers of cancer diagnoses have changed since last March.

Data story

Published: 27/05/2021

The Covid-19 pandemic has had a significant impact on cancer services. Referrals, screening services and outpatient appointments were disrupted, contributing to a 42% fall in the number of cancers diagnosed between March and May 2020, from 24,606 to 14,375. The way that patients accessed a diagnosis also changed.

The number of cancers diagnosed following a two-week wait GP referral decreased by 43% between March and May, while the number diagnosed via another type of GP referral fell by 54% over the same time period.

The largest decrease was seen in the number of cancers diagnosed following referral from a national screening service, which fell by 90% from 1,679 in March to only 171 in May. While screening services were not officially suspended during the pandemic, decisions to pause and restart breast and bowel screening services were made locally from March, and invitations for cervical screening were suspended from April to June.

In contrast, diagnoses following an emergency presentation, such as at A&E, began to increase from 3,250 in April to a high of 4,985 in July. This is particularly concerning as early diagnosis is vital to improve outcomes, and emergency presentation often means that the cancer has progressed to a later stage.

The total number of cancers diagnosed has increased since May, and cancer services were able to maintain higher activity levels during the second wave of the pandemic. However, diagnoses remain lower than in previous years, suggesting there are people living with cancer who have not yet been diagnosed.

To prevent the number of these missing diagnoses from growing, diagnoses each month need to return to at least pre-pandemic levels. Supporting people to come forward with suspected cancer symptoms and ensuring that services have sufficient resources to meet increased demand should be a priority.

Number of cancers diagnosed by route to diagnosis 27/05/2021

Chart

Note:  

‘Other’ includes outpatient referrals, inpatient admissions, death certificate only, and unknown routes. ‘Other GP referral’ includes routine and urgent referrals where the patient was not referred under the two-week wait route for suspected cancer. Rapid registration data is lower quality than National Statistics cancer registration data, and figures for the most recent months are likely to be incomplete. More detail about uses and limitations can be found here.

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