More late-stage cancers being diagnosed after screening delays, charity says

‘Crisis’ after 250,000 fewer people screened in 2020 than 2019, Irish Cancer Society chief says

Higher numbers of late-stage cancers are being diagnosed as a result of screening delays caused by the Covid-19 pandemic, the Irish Cancer Society has said.

The charity also said 250,000 fewer people were screened for cancer in 2020 compared with the previous year.

There is "a cancer crisis" in the State right now, the chief executive of the organisation, Averil Power, said.

Ms Power was speaking at an event hosted by the Think Tank for Action on Social Change (Tasc), to discuss the state of healthcare in Ireland and the impact of Covid-19 on growing health inequalities.

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She said while there were “challenges” prior to Covid-19, cancer survival rates had improved, but the pandemic “disrupted every single part of the cancer care continuum from screening to diagnostics to treatment and end-of-life care”.

“Screening was paused in March 2020 and while CervicalCheck and bowel screens started to resume in July and August, BreastCheck didn’t get back into operation until October.

“Taken across those three programmes, a quarter of a million people, 250,000 less people were screened in 2020 compared to 2019,” Ms Power said.

Backlog

“There’s still a huge backlog in the screening services, particularly BreastCheck. GP attendance has been down significantly throughout the pandemic.”

She said GP attendance was down for a mixture of reasons, such as cost, difficulty accessing in-person services and fears around Covid.

“Even where patients had presented with worrying cancer symptoms, where GPs had felt they needed referrals, people have faced huge challenges in getting access to diagnostic tests. As a result of this, we’re seeing a lot of later-stage cancers now being diagnosed,” she said.

“During the pandemic, there was a big drop, particularly last year, in cancer diagnostics but, of course, cancer hasn’t gone away, it’s just hiding behind the chaos caused by Covid-19 and caused by the cyberattack.

“What that means is we’re seeing some people coming forward now being diagnosed in later stage but we also know there’s so many people in our communities, particularly in our disadvantaged communities, who haven’t come forward.”

Inequalities

Tim Collins, chief executive of the Irish Heart Foundation, said the pandemic had "worsened health inequalities".

“There was this narrative at the beginning of Covid that it was a great leveller, that everybody was equally exposed to this virus no matter where they came from and whether they were living in an affluent area or a disadvantaged area, but that’s not the case,” he said.

“Covid has actually widened health inequalities because the incidence was higher in deprived areas and it impacted more on people living with chronic disease and there are more people living with chronic disease in deprived areas.”

He said heart attack presentations reduced during the pandemic, but life-threatening complications increased.

“Waiting lists grew and that was down to the curtailment of services such as cardiac rehabilitation and heart failure clinics where staff were moved on to the frontline and these clinics were slowed down and in some cases stopped,” he said.

Covid-19 had shown the State that “big problems require new thinking”, he added.

“The problems of waiting lists and staff shortages and bed capacity won’t be solved with a few more beds or another waiting list initiative,” he said.

“We’ve known for decades that 80 per cent of premature heart disease and stroke is preventable and if we really want to tackle the toll of death and disability from cardiovascular disease, we need to focus more resources on helping people to live longer healthier lives rather than focusing on almost exclusively treating established disease as we currently do.”

Sarah Burns

Sarah Burns

Sarah Burns is a reporter for The Irish Times