COVID-19 referral drop fears for lung cancer patients in Wales

Confusion over the symptoms of lung cancer and COVID-19 may be responsible for a worrying drop in the number of people being referred for lung cancer tests, a major report on how cancer is diagnosed in Wales has found.

All cancer types, referrals from GPs for suspected lung cancer were hardest hit during lockdown. The inquiry by the Cross Party Group on Cancer (CPGC) in the Senedd also found that they have been the slowest to recover. 

In August there were around 8,600 urgent referrals for suspected cancer in Wales, 9% fewer than the same time the previous year. Whereas lung cancer referrals were down 26% in August compared to the same time in 2019. During the lockdown in April, there was a sharp 72% drop in lung cancer referrals compared to the previous year. 

In order to cope with the growing and worrying backlog of undiagnosed and suspected cancer, the report calls for a national recovery plan for Wales which maps out how cancer and diagnostic services will bounce back from the impact of the COVID-19 pandemic.

“We cannot wait for the pandemic to end. With every moment that passes, a wave of undiagnosed cancer cases is building,” said Cancer Research UK’s chief executive Michelle Mitchell. “Nowhere is this clearer than for lung cancer, which has not recovered in terms of the numbers of people being referred.”

Encouraging people to see their GP

The CPGC inquiry details that the Welsh Government and NHS Wales should do more to encourage anyone with concerning symptoms that may be cancer to seek help. One of the ways they could do this is with a wide-ranging mass media communications campaign which has an initial focus on lung cancer. It should also provide reassurance that people can be seen and treated safely. 

The chairman of the Cross Party Group on Cancer, David Rees MS, called the latest lung cancer referrals data “hugely worrying”.  “Given that a cough is one of the principal symptoms of COVID-19, our report highlights that it may be more difficult for people to associate a cough with cancer. An awareness campaign could help explain the difference between a cough for COVID-19 and lung cancer by encouraging people to see their GP if their symptoms have lasted a long time.”

The report also outlined the need to ensure cancer services are fit for the future, which requires addressing critical chronic staff shortages in cancer care that existed before the pandemic.

Every year, around 2,500 people are diagnosed with lung cancer in Wales. Before the pandemic, 75% of lung cancer cases in Wales were diagnosed at a late stage (stage 3 or 4).

Sadly, more people die from lung cancer than any other cancer type in Wales, but if it’s found at an early stage it’s more likely treatment will be successful, and the chances of survival will be higher. For many people with lung related symptoms, it won’t be cancer, but it’s just as important as ever that people speak to their GP and attend follow-up tests. 

Planning for the future

In addition to addressing staff shortages, the report also recommends the urgent reintroduction of the Single Cancer Pathway – the Welsh Government cancer waiting times target that patients are tested and receive treatment within 62 days of cancer being suspected.

“A new cancer strategy for Wales, with the Single Cancer Pathway at the heart of it, will be critical if we are to diagnose more cancers earlier. The Welsh Government cannot wait and must make this a priority,” said Mitchell. 

Rees echoed calls for the reintroduction of the Single Cancer Pathway to help services recover and ensure people with concerning symptoms feel confident about contacting their doctor. He also highlighted the importance of a national recovery plan. 

 “There are rarely such things as silver bullets. However, the evidence is clear that diagnosing more cancers at an earlier stage, when they are more treatable, offers the best hope of saving more lives. This is why we must have a plan to recover cancer services as quickly and safely as possible.”