Thousands with bowel cancer diagnosed too late due to staffing crisis

NHS staffing shortage means more than 1,100 people with bowel cancer in England are being diagnosed too late each year

  • A lack of specialist staff means thousands of people are not being referred
  • Tests are harder to access in England than in Scotland, Cancer Research UK says
  • It means those with early stages of bowel cancer may ‘slip through the net’
  • If they fail to receive an early diagnosis, their survival odds reduce drastically 

Thousands of people with bowel cancer in England are being diagnosed too late because of NHS staff shortages, according to Cancer Research UK.

More than 1,100 people are ‘slipping through the net’ each year because there is a lack of specialists to conduct tests. 

Colonoscopies looks for pre-cancerous growths in the bowel, but a referral is harder to access in England than in Scotland because the criteria threshold is higher. 

It means many people fail to receive an early diagnosis. Their survival odds reduce drastically as a result. 

In England, more than half of bowel cancers with a known stage are diagnosed at a late stage.   

NHS staffing shortage means thousands with bowel cancer in England are being diagnosed too late each year, according to Cancer Research UK. NHS England have chosen a higher cut-off point to NHS Scotland for a referral following a stool screening test (stock)

Most people are diagnosed with bowel cancer over the age of 60. Therefore, the NHS runs a bowel screening programme for over 60s.

The bowel cancer screening test, known as FIT, looks for hidden blood in the stool, called haemoglobin, which can be an early sign of bowel cancer.  

If the FIT test, introduced in England last year and Scotland two years ago, finds anything unusual, that person might be asked to have further tests to confirm or rule out cancer.

It is up to each individual health system to decide what level of haemoglobin warrants referral for further cancer tests.

This, CRUK say, is where patients are missing out on potentially life-saving early diagnoses largely due to a lack of specialist staff.  

NHS England have chosen a higher cut-off point to NHS Scotland for a referral following a stool screening test. 

It says stool must contain 120 micrograms of haemoglobin per gram of faeces compared with 80 micrograms.

This means that in Scotland, the NHS refers people who have between 80 and 120 micrograms of haemoglobin, when the NHS in England does not. 

Cancer Research UK has calculated that if the NHS in England referred people with the same hidden blood levels as Scotland, there could be an additional 2,000 colonoscopies per month in England – 24,000 per year.

Although many colonoscopies would not turn out to be cancer, the NHS in England does not have enough special staff to conduct the tests. 

If there were enough staff, some 1,100 bowel cancer patients in England could be diagnosed early every year, CRUK says. 

Already one in 10 diagnostic posts are vacant in England. And the demand for staff is rising. 

Sara Hiom, Cancer Research UK’s director of early diagnosis, said: ‘The UK’s bowel cancer screening programme is very effective at detecting cancer early. 

‘But we’re concerned that NHS staff shortages are having a direct impact on the ability to diagnose more patients at an early stage – something that the Government committed to doing last year. 

‘People shouldn’t be slipping through the net.’

‘Improvements to cancer screening in the UK need to be made quickly and safely to ensure the NHS can diagnose people earlier.’

Around 363,000 people are diagnosed with cancer each year in the UK but by 2035, that is likely to increase to around half a million people.

Bowel cancer is one of the most common forms of the disease – 42,000 people are diagnosed each year in the UK. 

Around 16,300 people die from bowel cancer every year.

When bowel cancer is diagnosed at the earliest stage, more than nine in 10 people survive their disease for at least five years. But when it is detected in the late stages, survival falls to less than one in 10.

MailOnline has contacted NHS England for comment.  

What is bowel cancer and what are the symptoms?

Bowel, or colorectal, cancer affects the large bowel, which is made up of the colon and rectum.

Such tumours usually develop from pre-cancerous growths, called polyps.

Symptoms include:

  • Bleeding from the bottom
  • Blood in stools
  • A change in bowel habits lasting at least three weeks
  • Unexplained weight loss
  • Extreme, unexplained tiredness
  • Abdominal pain

Most cases have no clear cause, however, people are more at risk if they: 

  • Are over 50
  • Have a family history of the condition
  • Have a personal history of polyps in their bowel
  • Suffer from inflammatory bowel disease, such as Crohn’s disease
  • Lead an unhealthy lifestyle  

Treatment usually involves surgery, and chemo- and radiotherapy.

More than nine out of 10 people with stage one bowel cancer survive five years or more after their diagnosis.

This drops significantly if it is diagnosed in later stages. 

According to Bowel Cancer UK figures, more than 41,200 people are diagnosed with bowel cancer every year in the UK. 

It affects around 40 per 100,000 adults per year in the US, according to the National Cancer Institute.

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