More work needed to reduce cancer ‘long waiters’ list, MPs told

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More needs to be done to reduce the list of so-called “long waiters” who are waiting for cancer care, MPs have heard.

In England, if a GP suspects a patient has cancer they are urgently referred to see a hospital specialist.

The NHS aims to make sure that patients start a first treatment for cancer within one month.

But about 16,000 people have been waiting for more than 62 days for a diagnosis or treatment, the Health and Social Care Committee of MPs heard.

The NHS estimates that about 12% of these, almost 2,000 people, will have cancer.

Meanwhile, officials have estimated that 36,000 fewer people than expected have sought care during the pandemic, either because they do not want to burden the NHS or because they are cautious about being in a health facility.

It comes as the NHS announced a £20 million push to speed up cancer diagnosis – including enabling GPs to send pictures of suspect moles to dermatologists for speedier assessment, a scheme to enable speedier prostate cancer diagnosis, and “lumps and bumps” clinics.

Dame Cally Palmer, national cancer director for the NHS in England, said that the NHS had maintained cancer treatment at 91% of pre-pandemic levels.

But she said that this “masks some variation in different tumour types” – for instance many fewer patients have sought care for lung cancer due to similarities with Covid-19 symptoms.

On the cancer “deficit”, she added that there had been an increase in “long-waiters” – those who have waited over 62 days after they have been referred for a diagnosis, and possibly for treatment, if the diagnosis is confirmed.

“That level is currently at 16,000 and the intention is to return that to pre-pandemic levels by March 2022,” she said.

“It has been coming down so it was considerably higher than that during the peak of the pandemic, but it has been steadily reducing.

“But clearly we need to do more to make sure that is properly addressed.

“The other important thing to say about the backlog of long waiters, is that 12% of those people will have cancer, so we know where we need to direct our efforts, which is the faster diagnosis of, or exclusion of, cancer.”

Meanwhile Dame Cally said that the health service was “concerned” about the number of people with symptoms of cancer who have not come forward for treatment.

“If we look at the number of first cancer treatments in 2019, compared with a number of first cancer treatments in 2020, we have a gap of 36,000 (in England),” she said.

“So that is obviously an issue of concern and that is to do with people not wanting to come to bother the NHS, or being concerned to come forward.”

Meanwhile Professor Peter Johnson, national clinical director for cancer for the NHS in England, said that he was “cautiously optimistic” that the NHS could achieve the aim of diagnosing three quarters of cancers at an early stage – a stage where potentially curative treatment might be possible – by 2028.

He said: “Now that’s a very stretching objective, our current figure is just under 55% of people (diagnosed) at an early stage.

“But if we can achieve that then we will be up there with the best of our European comparators.”

Asked if the goal was achievable, he replied: “Clearly there was no anticipation of the huge disruption that coronavirus would cause to the health services as a whole when we set that ambition – I am cautiously optimistic.

“I think not only the things that we have in place such as rapid diagnostic centres and our lung health checks and screening programme for lung cancer, but also some of the innovations and some of the new things that we’ve got in the pipeline – which, admittedly, we don’t know yet whether they’ll deliver for us – but things like the blood test to pick up cancers at a very early stage by looking at minute amounts of circulating DNA.

“If they do what we hope they will do, then they will really give us a very rapid leg-up and something which I think will accelerate progress very markedly in the next few years.”

It comes as the NHS announced plans for the expansion of “teledermatology” which means that GPs with concerns about suspect moles can send photographs to hospital doctors to enable a faster diagnosis of skin cancer.

The funds will also be used to enable nurses to refer patients with suspected prostate cancer for an MRI scan, rather than patients needing to wait for an appointment with a consultant.

And so-called “lumps and bumps” clinics will offer examinations and same-day ultrasounds, and a cancer symptom hotline, which will see nurses give patients advice about concerning cancer symptoms and make referrals over the phone.

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