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Ben Lees considers the importance of early diagnosis of cancer, the benefits to patients and the NHS, and proposals for improvements.
By Ben Lees
I recently read an article with interest covering analysis undertaken by Incisive Health and commissioned by Cancer Research UK which studied the benefits of early diagnosis of cancer.
The study was initiated to determine whether there were financial benefits for the NHS if cancer was detected in its earlier stages (stages 1 and 2) as opposed to when cancer had reached the later stages (stages 3 and 4).
The report analysed the associated costs with treating colon, rectal, ovarian and lung cancer at stage 1 and at stage 4. The findings demonstrate that, overall, treatment costs for cancer found in the late stages were nearly two and a half times more than the treatment costs incurred of cancers detected early on.
With this information, Incisive Health questioned why the NHS was reticent to making early cancer diagnosis a priority and emphasised the improvement in survival rates for patients diagnosed earlier as opposed to those diagnosed later; a significant and widely recognised consensus.
As well as an improved survival rate, the study found the NHS could realise the following financial benefits by ensuring standards are raised to the same as the current highest performing areas in England:
1. For colon cancer, over £24 million could be saved and 4,500 patients benefitted;
2. For rectal cancer, nearly £10 million could be saved and 1,700 patients benefitted; and
3. For ovarian cancer, over £16 million could be saved and 1,400 patients benefitted.
For lung cancer, whilst savings can be made and over 3,400 patients would benefit, due to the highest levels of recurrence in this type of cancer, the financial benefits are not so great and therefore, for statistical purposes are difficult to determine. However, such savings as outlined above create the opportunity for the NHS to use finances elsewhere, for instance, towards research and development.
Alternatively, the savings made could be used to fund early diagnosis programmes and better treatments for those who need them. The report states that there is now good evidence that earlier diagnosis can be effectively encouraged, through a combination of screening, public awareness, clinician education and better access to diagnostics.
The report calls for all of those in a position of national leadership, for instance, the Department of Health, NHS England, Public Health England and the royal colleges to re-affirm their commitment to delivering earlier diagnosis of cancer. It considers that future assessments of the costs and benefits of early diagnosis programmes, such as awareness interventions and efforts to expand access to diagnostics, should explicitly take into account the potential to avert treatment costs.
I fully support this view and I agree with the recommendation that all CCGs and local health and wellbeing boards should set out plans to encourage earlier diagnosis of cancer and set targets for earlier diagnosis and a method of measuring this. In particular, this should be a priority for the lowest performing areas in England with the lowest early diagnosis rates.
Sadly, not all cancers can be treated and not all patients reap improved quality of life and there is a general consensus that this is more common for those who have been diagnosed at stages 3 or 4. We at the Clinical Negligence Team act for patients or their family members when a late diagnosis of cancer as a result of negligent medical treatment has resulted in a reduced quality of life or tragically, a fatality and the evidence obtained is often that the patient’s suffering could have been avoided or lessened had the cancer been diagnosed at the earlier time.
Having acted for Clients in such a position, I hope to see early diagnosis programmes being implemented.