Guest blog by Deborah Alsina, Chief Executive, Bowel Cancer UK
Recently new figures were released showing that survival rates from bowel cancer are improving, especially one-year survival rates for men.
Currently the one-year survival rate for bowel cancer is around 70% for men and women in England. However, this overall figure masks regional variation. For example, the Kent & Medway Cancer Network area has an almost 11% lower one-year survival rate for bowel cancer than the Dorset Cancer Network area. There is a similar variation on five-year survival rates, with people in the North East London Cancer Area (47%) having a 13% lower five-year survival rate than people in the Dorset Cancer Network (47% compared with 59.8%).
The figures released by ONS do not break down survival rates by stage of disease, but we know that more than 90% of people diagnosed with bowel cancer at the earliest stage of the disease go on to survive for more than five years. Unfortunately, fewer than 9% of people with bowel cancer are diagnosed at this stage and around 25% of patients are diagnosed as an emergency where outcomes are frequently poorer.
At Bowel Cancer UK we believe that this must be addressed and that bowel cancer patients should be able to expect prompt diagnosis and the best treatment and care wherever they live in the UK, rather than worry about their postcode. With the new localised commissioning structures in place since the beginning of April, there is an opportunity for areas to improve. However we are concerned that some areas may begin to lag further behind unless positive action is taken now. We would urge commissioners to address variations as a priority and to ensure there is a joined up approach across public health and the NHS.
We believe there are two key areas that need renewed and sustained focus. Firstly it is essential that people with symptoms are referred for high quality diagnostic testing services promptly so that bowel cancer can be ruled out quickly. This will require both improvements in performance in some endoscopy units and sustained investment – the Department of Health has shown that endoscopy capacity needs to double over the next five years in order to meet rising demand – yet investment appears slow. Without this investment waiting lists will grow and essential surveillance services for higher risk groups will also continue to suffer. This could lead to more patients being diagnosed at a later stage when not only are outcomes worse but treatment more expensive.
Secondly, we must take a unified approach and continue to raise awareness of the disease, its symptoms and the screening programme to encourage people to take action. Bowel cancer screening uptake is simply too low across all four nations of the UK – currently under 60% – and in some areas significantly lower. We must target into ‘harder to reach’ communities to change this and to increase uptake, as screening has been proven to save lives through detecting cancer earlier or preventing it from developing. Primary care engagement will be important in achieving this. We must also find a way to ‘mainstream’ the disease so it becomes acceptable for people to both know and act upon the symptoms.
So whilst the progress shown by the recent survival figures is encouraging and testimony to the hard work and commitment of many individuals and organisations, this is not the time for complacency. People are still dying from a cancer that is treatable, especially when caught early. Improving survival rates and earlier detection of the disease must therefore continue to be a priority for the new NHS.
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