Since the first coronavirus lockdown, the number of people diagnosed with bowel cancer in England has fallen sharply, according to a study led by the University of Oxford.
Between April and October 2020, 3,500 fewer patients than expected were diagnosed with bowel cancer in England. Since the disease is more likely to be curable if it’s detected at an early stage, these results suggest that many patients may die unnecessarily, researchers said.
Compared with an average month in 2019, the monthly number of referrals by GPs to hospital clinics for investigation of possible bowel cancer reduced by 63% during April 2020 – from 36,274 to 13,440.
During the same period, the number of colonoscopies performed fell by 92% – from 46,441 to 3,484, the monthly number of people with confirmed bowel cancer referred for treatment fell by 22%, and the number of operations performed fell by 31%.
Lead author Professor Eva Morris from the Nuffield Department of Population Health at the University of Oxford, said the results reflect “serious disruption” in the normal identification and treatment of patients with bowel cancer.
“Early diagnosis is key to obtaining the best survival for bowel cancer so these delays in diagnosis are likely to have severe consequences on survival rates from the disease,” she said.
Keith Dawber experienced a change to his bowel habits in March 2020, but his GP surgery was closed and he had to wait until June to speak to his doctor over the telephone. “My symptoms started at a really bad time as I couldn’t speak to my GP straightaway and as the months went by, I was seeing more blood in my stool,” he said.
When he did finally speak to his GP he was referred for further testing and, in August 2020, was diagnosed with stage 3 bowel cancer. He had surgery followed by chemotherapy, which ended on Christmas Eve, and he’s now waiting for a scan to see if he needs further treatment.
Professor Sir Mike Richards, a trustee of Cancer Research UK, believes the drop in hospital referrals may be linked to people’s fear of catching the virus in healthcare settings as well as the government’s call to “stay at home” and “protect the NHS”.
Bowel cancer screening was temporarily paused during the first lockdown. The first lockdown had a short-term impact on the numbers of people being treated, the study showed.
While the NHS managed to rapidly adapt services to deliver care safely, said researchers, treatment rates had only just returned to normal by October 2020. Given the current pressure on the NHS as a result of the second wave of Covid-19 cases, it’s likely diagnostic and treatment rates may have fallen again.
Chris Cunningham, a colorectal surgeon, said: “Unfortunately, this new surge in Covid-19 cases is now hitting surgical capacity again and so we need urgent action to balance resources between treating Covid-19 and cancer to ensure the number of avoidable deaths is kept at a minimum.”
Despite the country being in a third lockdown, those who do spot a change that could signal bowel cancer are urged to seek help as soon as possible.
“We need to get this message out there,” said Brian Nicholson, a GP involved in the University of Oxford study. “If people have symptoms like altered bowel habit or blood in their poo that may suggest bowel cancer, they must talk to their GPs as soon as possible, as early diagnosis saves lives.
What are the symptoms of bowel cancer?
More than 90% of people with bowel cancer have one of the following combinations of symptoms, according to the NHS.
- a persistent change in bowel habit – pooing more often, with looser, runnier poos and sometimes tummy (abdominal) pain
- blood in the poo without other symptoms of piles
- abdominal pain, discomfort or bloating always brought on by eating – sometimes resulting in a reduction in the amount of food eaten and weight loss
There are also some cases where bowel cancer might cause a blockage in your bowel, stopping waste from passing through. Symptoms of a bowel obstruction, which is a medical emergency and requires a trip to A&E, can include: intermittent, and occasionally severe, abdominal pain brought on by eating; unintentional weight loss with persistent abdominal pain; constant swelling of the tummy or being sick, both with constant abdominal swelling.
Dr Lisa Wilde, director of research and external affairs at Bowel Cancer UK, tells HuffPost UK: “Every year in the UK over 42,000 people are diagnosed with bowel cancer, making it the fourth most common cancer. Raising awareness of symptoms of the disease is vital, as it’s treatable and curable, especially if diagnosed early.
“We urge everyone to familiarise themselves with the symptoms and contact their GP as soon as possible if they have bleeding from their bottom and/or blood in their poo, a persistent and unexplained change in bowel habit, unexplained weight loss, extreme tiredness for no obvious reason, and a pain or lump in their tummy, to help ensure the best possible outcome.”