Coronavirus may cause 3,500 deaths in England from four main cancers

Study shows diagnosis delays most likely to affect young or middle-aged in next five years

About 3,500 people in England may die within the next five years of one of the four main cancers – breast, lung, oesophageal or bowel – as a result of delays in being diagnosed because of Covid-19, research shows.

Many of these will be young or middle-aged people, say the researchers in the Lancet Oncology journal.

“Our findings demonstrate the impact of the national Covid-19 response, which may cut short the lives of thousands of people with cancer in England over the next five years,” said Dr Ajay Aggarwal from the London School of Hygiene & Tropical Medicine, who led the research.

Routine cancer screening was suspended during the lockdown, the authors said. So was the routine referral to hospital outpatient departments of people with symptoms that could be something else but also might possibly be cancer. Only those deemed to need emergency care by the GP or those who go to A&E are being picked up. Inevitably, those are people with more advanced cancers. If cancer is picked up at an earlier stage, successful treatment and survival are much more likely.

“Whilst currently attention is being focused on diagnostic pathways where cancer is suspected, the issue is that a significant number of cancers are diagnosed in patients awaiting investigation for symptoms not considered related to be cancer. Therefore we need a whole system approach to avoid the predicted excess deaths,” said Aggarwal.

On average, those who die would have lived for 20 more years if their cancers had been identified promptly, without the delay caused by the coronavirus pandemic, the paper shows.

“These estimates paint a sobering picture and reflect the many young people who are affected by cancer in the prime of life during their most productive years,” said Prof Richard Sullivan from King’s College London, the study’s co-author.

The absence of routine screening, the reluctance of people to get in touch with their GP and other delays in diagnosis could lead to a rise in breast cancer deaths by an estimated 8–10% (equivalent to between 281 and 344 additional deaths by 2025). colorectal (bowel) cancer deaths by 15–17% (1,445–1,563), a 5% (1,235–1,372) rise in lung cancer deaths, and a 6% (330–342) rise in deaths from oesophageal cancer over the next five years.

The researchers are calling for social media campaigns to make people aware that the risk of death from cancer by delaying diagnosis may for many people outweigh the risk of dying from Covid-19. Healthcare professionals need to be properly informed of how to manage any Covid-19 risks from diagnostic procedures.

Aggarwal said they had estimated there would be nearly a 20% increase in avoidable bowel cancer deaths. “To prevent this becoming a reality, it is vital that more resources are made urgently available for endoscopy and colonoscopy services which are managing significant backlogs currently, and that patients present promptly to their GP if they have any concerning gastrointestinal symptoms,” he said.

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Sarah Boseley Health editor

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