Britain’s COVID-hit cancer care needs a diagnostic revolution

We have been urged to join a “great national effort” to dramatically increase booster vaccinations, and the nation has stepped up. But the healthcare community cannot respond indefinitely to coronavirus variants. There are many other competing priorities that, in the longer view, pose a much larger threat to our population. Foremost among these is cancer care.

The pandemic has devastated all recent efforts to improve cancer recovery and survival in the UK. With cancer, the impact of Covid has come as a sledgehammer to an already shaky set-up, affecting both the time to diagnosis and the time from diagnosis to treatment. And with a progressive, aggressive condition such as cancer, delays cost lives.

A key contributor to delay in diagnosis is that the label of potential cancer is applied too early and too arbitrarily. A patient, for example, may go to the GP with a cough and after a short screening consultation be placed on a high-risk pathway (the two-week wait — 2WW — fast-track pathway) or on to a slower-burn, six-week diagnostic pathway. The stratification is done with too little information in many cases.

We could achieve so much more if we had better information to determine cancer likelihood. That comes from rapid diagnostic imaging and blood tests and, for some, quick access to a focused ’scopy — gastroscopy, cystoscopy, bronchoscopy and so on. Until the diagnostics are complete, treatment for cancer, as with other debilitating conditions, cannot start.

There is a compelling need for diagnostics to be “front-loaded” so that the prioritisation of patients becomes markedly more efficient. The government’s commitment to 40 community diagnostic hubs is a major step in the right direction.

As someone who works primarily in the NHS but also in the independent sector, I believe collaboration and partnership between all parts of the healthcare sector makes huge sense. The latest guidance issued by the NHS states that local trusts should continue to forge arrangements with the independent sector to help mitigate the impact of Covid, and that would be a benefit to all patients.

The longer view — the clinician’s view — is that when Omicron and its succession of future mutations have passed, the UK can still be expected to have a poor record of cancer outcomes. There is no magic wand solution but a national impetus to offer all those with symptoms ready access to high-quality diagnostics is a good place to start. It’s achievable and, most importantly, is bound to save many thousands of lives.

Dr Jonathan Richenberg is a consultant radiologist, and Diagnostic Clinical Director at Rutherford Diagnostics