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An agile cancer service is vital for the future

Professor the Lord Ara Darzi
by Professor the Lord Ara Darzi | Opinion

14 September 2023

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A man sitting in an NHS waiting room.
Photo by Kerry Harrison


Professor the Lord Ara Darzi is Co-Director of the Institute of Global Health Innovation at Imperial College London and Paul Hamlyn Chair of Surgery. He is a Consultant Surgeon at Imperial College NHS Trust and the Royal Marsden NHS Foundation Trust and is one of the experts helping to shape our Manifesto for Cancer Research and Care.

Our Manifesto, which will be published in November, will set out how the next Government can transform cancer outcomes for all and how we can take action to reduce health inequalities.

Our nation is blighted by inequality.

There are vast disparities in incomes, earnings, wealth, education and life expectancy.

Ethnicity, gender and age are drivers of inequality, and so is geography.

But perhaps the greatest injustice of all are inequalities in health.

In the case of cancer, we know we are all at risk. One in two of us will be diagnosed with the disease during our lifetimes.

But cancer does not affect us equally. Research shows that people from more deprived areas are 17% less likely to survive diseases such as rectal cancer, compared to those from the least deprived areas. Similar patterns are seen with cancers of the breast, prostate, and bladder.

The COVID-19 pandemic has shown how people living in deprived areas, of differing ethnicities, and with existing health conditions are disproportionately affected by illness. Cancer is no different.

These inequalities do not just affect whether people survive cancer. They determine how cancer is screened, diagnosed, and treated. This is why it is so important that addressing inequalities will be embedded throughout Cancer Research UK’s Manifesto for Cancer Research and Care.

As the co-director of the Institute of Global Health Innovation, I know how important it is to engage people from all backgrounds when introducing advances in healthcare.

When we examined the impact of data driven health innovations such as Artificial Intelligence (AI), we found critical knowledge gaps in different populations, hindering their ability to benefit from them.

That is why our research on the use of AI readers in breast cancer screening has involved extensive work with the public. It is essential to appreciate a breadth of views – from identifying the problem, designing the solution, to executing the change – when developing and implementing a novel technology.

It is also crucial to acknowledge that the way in which we deliver cancer care may not meet everyone’s requirements. We need to provide agile cancer services that can adapt to the differences between people.

This may involve leveraging the range of data we have about a person to tailor therapeutics and target care. It will also include improvements to existing processes, for example, by providing clinic letters, and other health information, automatically translated into a patient’s preferred language.

Personalisation of care remains the ultimate goal.

Delivering this high standard of care will be challenging.  The NHS is facing a looming shortfall of oncologists, radiologists, and specialist cancer nurses by 2030.

Estimates suggest we need to double the current diagnostic radiography workforce each year until 2026 to meet demand. There are also shortages of allied healthcare practitioners who are essential to providing a smooth cancer pathway.

New technology such as AI can only alleviate some of these pressures. A cancer workforce sufficient to meet the growing needs of the UK population is essential. But so too is training to ensure care is delivered to an equally high standard across the country.

Transforming cancer services is not just about improving overall outcomes. It’s about improving the lives of the individuals and communities affected by cancer.

To do this it is imperative that we strive for an equitable healthcare service.