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Over 100,000 cancer patients each year diagnosed too late

Cancer Research UK says thousands more radiologists, oncologists and radiographers needed to hit early diagnosis targets

Mark Gould

Monday, 02 September 2019

Each year around 115,000 cancer patients in England are diagnosed too late to give them the best chance of survival, according to new calculations* from Cancer Research UK (CRUK).

This means that nearly half of all cancers diagnosed with a known stage in England are diagnosed at stage 3 or 4. And of these, around 67,000 people are diagnosed at stage 4 leaving them with fewer treatment options and less chance of surviving their disease, CRUK says.


CRUK says the numbers may be even higher because there is no record made of the stage at which 19% of more than 300,000 new cancer patients a year are diagnosed in England.

The government’s long-term plan for the NHS sets an ambitious target of three quarters of cancers to be picked up early by 2028 – at stages 1 and 2 when a cure is more likely. By that time, there will be an estimated 320,000 cancers, so at least 100,000 more will have to be caught early to hit the target.

By 2035, more than 500,000 people will be diagnosed with cancer in the UK, compared with nearly 360,000 today. With an ageing population, more tests will need to be carried out to diagnose more cancers and diagnose them earlier.

To treat them CRUK research has estimated that by 2027, the NHS will need:

  • An additional 1,700 radiologists, increasing the total number to nearly 4,800
  • An additional 1,845 oncologists to a total of 3,000
  • Nearly 2,000 more therapeutic radiographers bringing the total to 4,800

Efforts to diagnose more patients at an early stage means more people being referred urgently for tests, a vital shift for prompt diagnosis and treatment. But increasing referrals have left diagnostic staff under great pressure because of vacant posts, a lack of funding to train new doctors and growing lists of patients.

CRUK says at least one in 10 of these posts is empty, so the government needs to urgently invest in the cancer workforce if they plan to save more lives now, and in the future. Without the staff, the government will not achieve its own ambition.

An underpowered workforce is not the sole reason for late diagnoses. Other factors include symptoms being hard to spot, GPs having too little time to investigate people thoroughly, low uptake of screening programmes or the cancer being advanced when detected.

But right now, staff shortages are affecting every part of the pathway. Dr Giles Maskell, Cancer Research UK’s radiology expert, said: “We can feel the bottleneck tightening in the NHS – the pressure is mounting on diagnostic staff. We don’t have nearly enough radiologists in the UK right now and far too many patients are waiting too long for scans and results.

“NHS staff are working as hard as they can, but we won’t be able to care for the rising number of cancer patients unless the resources are found to train more specialist staff. Extra scanners are welcome, but they will achieve nothing without staff to run them and experts to interpret the scans. It’s like buying a fleet of planes with no pilots to fly them.”

The Department of Health and Social Care said: “Cancer is a priority for this government. Survival rates are at a record high and, in the NHS long-term plan, we committed to detecting three quarters of all cancers at an early stage by 2028.

“We now have over 900 more diagnostic radiographers working in the NHS when compared with 2017, and the record £33.9bn extra we’re investing in our NHS every year will ensure we can support the health service with the staff it needs for the future."


*Securing a cancer workforce for the best outcomes. A report prepared by Cancer Research UK, 2019- The report provided estimates for the number of staff needed in 2027 based on 2016 staff numbers. The estimates have been revised based on 2018 staff numbers.

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