More than a third of patients in England, Scotland and Wales find that they only get the disease when they are treated, according to research published in the journal Lancet Oncology. People who end up in A&E, sometimes after multiple trips to their doctor, are less likely to survive the disease, especially if they have cancer of the stomach, intestine, liver, pancreas, lung or ovaries. The International Cancer Benchmarking Partnership and Cancer Research UK (CRUK) examined cancer data and linked hospital admissions to 14 regions in six countries: Australia, Canada, Denmark, New Zealand, Norway and the United Kingdom. Cancer data often lag behind – data collected between 2012 and 2017 – but CRUK said it fears the outlook is even worse now after the Covid-19 pandemic. Researchers at University College London examined eight major cancers and found that more than a third of patients in England (37%), Wales (37%) and Scotland (39%) were diagnosed after being rushed to hospital. In Northern Ireland, which was measured using a different definition, emergency presentations accounted for more than a quarter (28%) of diagnoses. England, Wales and Scotland ranked worse than all other regions and countries in the study except New Zealand, where the rate was 43%. The lowest rate recorded was 24% in Victoria, Australia. “For months now, we have been warning that cancer survival could decline due to the pandemic,” said Michelle Mitchell, chief executive of CRUK. “The UK is already lagging behind in terms of cancer survival – this study helps us understand why, showing that countries with higher levels of emergencies have lower survival rates.” He added: “If we want to create a world-class cancer service, we need to learn from comparable countries and ensure that fewer patients are diagnosed with cancer after an emergency referral or an A&E trip. “We would like to see governments across the UK take bold steps in this regard as part of their cancer plans, so that by 2032, less than 10% of cancer cases will be diagnosed through emergency routes.” In the case of specific cancers, 46% of people with pancreatic cancer were diagnosed as a whole in an emergency, but the rate was much higher in Britain, 56% in England and Wales and 59% in Scotland. In New Zealand, 60% of patients were diagnosed with pancreatic cancer in an emergency, and in Norway it was 55%. However, the figures for Ontario and Alberta, both in Canada, were 35% and 41% respectively. Overall, 34% of people in England and Wales and 35% in Scotland were diagnosed with bowel cancer in an emergency, but the rate was 27% in Ontario and 32% in New South Wales in Australia. Meanwhile, 47% of people in the UK are diagnosed with emergency liver cancer, compared with 40% in New South Wales, 32% in Alberta and 28% in Ontario. In Norway the percentage was 51%. The study found that people aged 75 and over were more likely to be diagnosed with an emergency, as were those with advanced cancer. Emergency diagnoses also resulted in a double risk of death in the next 12 months compared to people who had been diagnosed at other times. Cancers that often had non-specific, vague symptoms, such as cancer of the pancreas, liver, lung, and ovaries, were also more likely to be diagnosed in A&E.
