Professor Karol Sikora on Twitter has highlighted the "staggering statistics" published by Macmillan Cancer Support. He points out that almost 50,000 people have missed their cancer diagnosis, and he says "Devastating. 24,000 who did start treatment were significantly delayed. Where have these patients gone? The tumours will still be growing. This will cost countless lives".
Based on comparisons with diagnostic rates last year, Macmillan Cancer Support estimated that there are 50,000 “missing” cancer diagnoses, with warnings the NHS may not cope when growing numbers come forward for checks. Macmillan defines the cancer backlog as everyone who is currently missing a cancer diagnosis, "which we would ordinarily expect them to have. This also includes everyone who is already ‘in the system’ waiting for treatment, scans or investigations for an existing cancer diagnosis".
Macmillan say that cancer services need to be protected to deliver even higher levels of activity than they did before the pandemic. This is needed to reduce the backlog for people waiting now and make sure it doesn’t grow.
The forgotten
Macmillan are calling for Ministers and NHS services across the UK to prove this won’t happen again, and to promise that cancer will become the ‘Forgotten C’.
It estimated that more than 47,000 people have “missed” a diagnosis in the UK since the first lockdown. Previous studies have estimated that between 20,000 and 40,000 diagnoses had been missed during the pandemic. However, the new data suggests that the numbers could increase further especially with so many people unable to get into see their doctor.
More effective use of AI to detect cancer
Improved technology might be a source of some better news for cancer patients. A company that specialises in AI-powered digital biomarkers from medical images, has announced a new method for lung cancer screening with a focus on the identification of stage 1 lung cancer.
Lung cancer is the third most common cancer in the UK. Normally around 46,400 people are diagnosed with it each year. There are two main types including:
- non-small cell lung cancer (NSCLC), and
- small cell lung cancer (SCLC).
If the lung cancer spreads to the lungs from somewhere else in the body. This is called lung metastases or secondary lung cancer. Cancer that affect the lung lining or pleura are known as pleural mesothelioma. Sometimes lung cancers can spread to other parts of the body including the brain. Early detection of lung cancer is therefore critical as a third of cases will spread too the brain.
The traditional difficulty with detecting and characterising lung cancers, especially at an early stage, has been the lack of accuracy with obtaining a good diagnosis, and so new methods are needed.
Median technologies say that their new iBiopsy®’s Lung Cancer Screening performance (LCS) for stage 1 lung cancer has good diagnostic accuracy with 93.1% sensitivity at 96.2% specificity. The higher specificity and sensitivity reduces the percentage of false negatives and false positives. False positives have been a recurring problem of lung cancer screening.
Endobronchial ultrasound (EBUS)
As described by Dr Neal Navani, Endobronchial ultrasound (EBUS) is very much the gold standard for diagnosing lung conditions. He says, "Endobronchial ultrasound is a relatively new diagnostic technique that can be used to investigate problems inside the lungs or in the chest area between the lungs. This is a difficult area to visualise and this used to be done using a combination of X-rays, CT scans and standard bronchoscopy. However, in order to obtain a reliable diagnosis of tuberculosis, sarcoidosis or cancer any follow-up usually had to include an invasive biopsy with an operation and an overnight stay in hospital. Today you can have a bronchoscopy with endobronchial ultrasound as a day case and you will usually be leaving for home within an hour of the procedure being completed".
Prof Sikora says that the missed diagnoses are across all types of cancer, "Prostate cancer diagnosis down almost a quarter, breast cancer down 12%. Women being diagnosed with advanced stage breast cancer as much as 48% higher at times than expected. Early diagnosis saves lives".
