Late cancer diagnosis costing lives and money

April 2017

Cancer

Country of origin: UK

The late diagnosis of almost all types of cancer usually means the disease has already spread within the body, making it less treatable, reducing a patient's chances of survival, and potentially increasing the cost of effective treatments according to a recent report.

This means an enduring aim of cancer treatment is to pick up the disease as soon as possible, so treatment is more likely to be effective.

The report predicted around 52,000 cases of four common cancers (colon, rectal, lung and ovarian) may be spotted too late every year, costing the NHS around an extra £150 million to treat.

Various theories have been put forward to explain why this is the case, including "patients put[ting] their heads in the sand when they feared cancer", and how "doctors are struggling to get patients seen quickly".

The report was produced by Incisive Health, a specialist health policy and communications consultancy, in collaboration with experts at Cancer Research UK, a leading cancer charity. It was funded by Cancer Research UK.

The report – titled "Saving lives, averting costs: an analysis of the financial implications of achieving earlier diagnosis of colorectal, lung and ovarian cancer" – presumed that early diagnosis is crucial, and aimed to uncover the financial implications of achieving earlier diagnosis for colon, rectal, non-small cell lung (the most common type of lung cancer) and ovarian cancers.

The report estimated the number of people currently diagnosed with cancer using national guidance and data sources. This included data on the stage of the cancer when it was diagnosed (where available), and the authors calculated the cost of treatment. They then modelled what would happen if the cancers had been diagnosed earlier.

The report found that in England there are marked variations in the proportion of patients who are diagnosed with cancer at an early stage.

For colorectal cancer, there is nearly a threefold variation between the highest and lowest performing local clinical commissioning groups (CCGs).

For lung cancer, the variation is nearly fourfold, and almost fivefold for ovarian cancer.

The report also found early-stage cancer treatment is significantly less expensive than treatment for advanced disease.

However, the costs of recurrence can be significant and should be taken into account when modelling overall cancer treatment costs.

Overall, late diagnosis is a major driver of NHS cancer treatment costs, the report found.

It also found that:
• Delivering earlier diagnosis for lung cancer would not be cost-saving, but would save lives.
• Taking the colon, rectal, lung and ovarian cancers together, savings of more than £44 million and health benefits for nearly 11,100 patients could be made if all areas achieved the best levels of early diagnosis.

Colon, rectal, lung and ovarian cancers account for approximately 21% of overall cancer diagnoses in England. If the findings for these cancers were replicated for all cancers, savings in treatment costs of just under £210 million would be realised, resulting in more than 52,000 people being diagnosed with earlier-stage cancer. This suggests that commissioners should develop plans with the expectation of being able to realise significant savings if they can deliver earlier diagnosis.
Even before new and potentially more expensive therapies are taken into account, the costs associated with treating cancer will increase as a result of rising numbers of cancer cases in the next 10 years.

The report concluded that, "The analysis presented in this report demonstrates that earlier diagnosis of cancer will deliver both an outcomes premium for patients and a financial dividend for the NHS through averted treatment costs.

"These findings create a compelling case for commissioners of NHS and public health services to act now to encourage earlier-stage diagnosis."

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