One year on: How has COVID-19 affected cancer services?

Figures released this week show the first year of COVID-19 and the impact on health services. The numbers lay bare what many have seen first-hand – the devastating impact COVID-19 has had on people with cancer, health service capacity and the efforts to recover.

They also give an indication of COVID-19’s legacy and the scale of the challenge. Disruption to cancer screening, diagnosis and treatment has led to more than 45,000 fewer people starting cancer treatment between the start of the pandemic and March 2021 – the so called ‘missing cancer patients’.

Here’s a breakdown of the figures. Screening was badly affected at the start of the pandemic, with bowel, breast and cervical screening programmes largely put on hold.

And with around 210,000 people being screened each week in the UK before the pandemic, we estimate that around 3 million people were waiting for screening by September last year.

Cancer screening services have worked hard to get back up and running again. But this disruption has impacted the number of people diagnosed through this route.

Around 9,200 fewer patients started cancer treatment after a referral from the screening programmes in England between April 2020 and March 2021 – a 42% drop compared with pre-pandemic figures.

A similar pattern is emerging in Scotland, with around 1,200 fewer people starting cancer treatment after being referred from an NHS screening programme between April and December 2020, a reduction of 62% compared to pre-pandemic.

But things are moving in the right direction. The latest figures show that the number of people starting treatment after a screening referral in March 2021 is up 3% on March 2019 in England.

Routine cancer screening invitations are going out and, in some areas, hubs and centres are inviting more people than usual to try to catch up with the people who weren’t invited last year.

Cancer referrals

Another area that has been heavily affected by COVID-19 was the number of people being urgently referred with suspected cancer symptoms by their GP.

Between March 2020 and March 2021, we’ve estimated that over 380,000 fewer people were referred than normal in the UK, with around 330,000 fewer referrals in England.

Urgent referrals for suspected cancer plummeted at the start of the pandemic, with 120,000 fewer people than normal being referred in April 2020 alone in England. Since then, the number of referrals has been climbing and was back around the normal monthly level in March 2021, with around 15,000 more people referred than in March 2019 in England.