Improving cancer survival relies on earlier diagnosis, but diagnostic services are under growing pressure, as Cancer Research UK Policy Manager Sara Bainbridge explains
There are more than 200 different types of cancer, so when someone sees their doctor with possible symptoms, getting the right diagnosis can be complicated. Diagnosing cancer early can make a huge difference – in some cases, survival rates are three times higher when the disease is diagnosed early.
So, to improve cancer survival, we need to make sure people get the tests they need at the right time.
Pathology plays a crucial role in cancer diagnosis and staging, helping to determine the best way to treat someone. Some types of pathology are more relevant to cancer, as they look at the biopsies of tumours (cellular pathology), blood samples (haematology) and the genetics of the cancer (molecular pathology).
But pathology – and other services providing diagnostic tests – are under pressure.
Can we cope with the growing demand for pathology services?
Whilst cancer survival is at its highest ever level, our health services are under considerable pressure. Increasing cancer incidence, an ageing population, and efforts to improve outcomes mean that the demand for cancer diagnostics has never been higher. There were around 357,000 new cancer diagnoses in the UK in 2014 and this is set to increase considerably as we live longer – around half of us will be diagnosed with cancer in our lifetime.
Previous research has shown that endoscopy and imaging services are performing more scans and tests than ever before, but they are struggling to meet demand. We’re hitting a diagnostic bottleneck with thousands of patients waiting too long for tests, results and to start treatment.
Ensuring diagnostic services can cope with future demand is essential if we are to improve outcomes for patients through early diagnosis.
Diagnostic services are all experiencing difficulties in staffing their services.
Our latest study has revealed that we face a severe crisis in pathology capacity within the next 5 to 10 years. There aren’t enough new pathologists in training to replace an ageing workforce. Immediate action is needed to avert a crisis in pathology capacity and ensure we have a service that is fit for the future. Without it waiting times are likely to increase as it takes longer to process and report all requests. This means more people will be left in limbo when they require tests, and it may delay a patients’ diagnosis and treatment.
What more could be done?
New approaches to diagnostic services, including pathology, need to be explored. This might mean different team-working, so that biomedical scientists or more junior doctors take on new tasks. There should also be efforts to network and consolidate services – which could improve efficiency by sharing test results and resources to reduce duplication.
We also want to ensure that pathologists still have time to take part in teaching and research. The discoveries of the future can only be achieved with the input of pathologists – people working in the NHS need the time and flexibility to undertake clinical research.
It is important to look ahead at the growing demand for cancer diagnosis, and changes to the types of tests we need, and plan the workforce accordingly. It takes over 10 years to fully train doctors to consultant level, so making sure our cancer services can deliver world-class outcomes in the future will need a long term strategy.
By 2020, over 750,000 extra endoscopies will need to be performed every year – that’s the equivalent of the population of Leeds. This rising demand has led to the government pledging more funding and starting a training scheme for 200 more non-medical endoscopists in the next couple of years. But we need similar action to be taken for those involved in imaging and pathology, so that there are enough staff in the short term. Without enough workforce, we will be letting down patients who deserve the best chance of survival through getting the tests and treatment they need, on time.