Cancer, COVID and Screening; Where do we go from here?

It is reported in the papers this weekend that thousands of lives may be lost to cancer because 250,000 patients were not referred to hospital for urgent checks.

Apparently, there was a 43% drop in referrals between the period April to June in England this year, that is 254,818 patients who were not referred.  Research by the Institute for Public Policy Research shows that this fall in number will result in cancers being spotted too late. 

It is suggested that this lack of referral in Britain will reverse a decade of progress in tackling the disease, with survival rates predicted to slump.  Even when people are referred to hospital, there are delays in accessing diagnostic services and treatment that could save lives.  Five-year survival rates for those diagnosed this year are set to drop from 16.2% to 15.4% for lung cancer, 85% to 83.5% for breast cancer and from 58.4% to 56.1% for colorectal cancer.  The Sunday Times goes on to tell us that this decline would represent a significant setback to treating cancer with outcomes equivalent to those in 2017, 2012 and 2010 respectively. This modelling puts us on an equivalence with such countries as Turkey and Lithuania before the pandemic. Britain is already bottom of an international league for cancer survival rates.

The Sunday Times goes on to tell us that last year’s The Lancet Oncology Journal found that although the UK’s performance had improved over the past 20 years, it was still seventh out of seven developed nations for five year survival.  The pandemic disrupted all four stages of cancer services:

  • Urgent GP referrals dropped by 43%, that is 210,000 people a week were affected by the halting of cancer screening
  • Diagnostic testing such as CT, MRI and endoscopy services decreased by up to 76%
  • Finally, treatments fell by as much as 40%.

These are terrible statistics and will result in the excess mortality as measured to be much higher than just COVID deaths alone during this period and for years to come. 

So, what does this mean and how can we address the Problem?

Here at The London General Practice we have access to state of the art imaging and diagnostic resources. We are also able to arrange same day referral if required and have direct contact with the leading physicians, surgeons and oncologists in their respective fields.

Throughout the pandemic, we have been open and continued consultation by video or face to face.  Now, with the relaxation of lockdown, we are encouraging our patients to take advantage of all the screening services which we offer.  All our doctors wear PPE and patients are triaged before entering the building to ensure that no patient with known COVID symptoms attends.

Screening is done to detect potential health disorders or diseases in people who are asymptomatic. That is, they do not have symptoms of the disease. 

The goal is early detection, which can result in lifestyle changes or surveillance to reduce the risk of disease or to detect it early enough to treat it most effectively. 

A screening test is valuable when it is able to detect potential problems whilst minimising unclear, ambiguous or confusing results. Whilst most screening tests are not 100% accurate, it is generally more valuable to have screening tests at appropriate times than to not have them at all. However, it must be remembered that some screening tests when used in people not at high risk of disease or if testing for very rare diseases can cause more issue than help. 

Here at The London General Practice we have evaluated all clinical guidelines and screening modalities for the major causes of morbidity and mortality and have come up with clinical pathways for the identification, evaluation and early diagnosis for these major diseases which, if discovered late carry significant morbidity and mortality.

It is apparent that there is no definitive consensus amongst medical professionals for early screening, but our pathways are drawn from NICE, The American Cancer Society and our peers at the very top of their professions, with their clinical academic experience.

Our pathways are very strict to ensure that you are not exposed to undue risks such as excess radiation or tests without definitive results.

However, they are flexible and customised to you as an individual, resulting in a fully bespoke medical report.

Follow our posts over the next few days to see our approach for screening for different cancers and conditions.

To learn more about Cancer or General Health Screening at The London General Practice please visit our web site.

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