A Spotlight on Bowel Cancer in Wales

Bowel cancer is the fourth most common cancer in Wales, but is the second biggest cancer killer. It shouldn’t be. The disease is preventable, treatable and even curable. Yet we hear directly from patients who struggle to be referred for diagnostic tests, or suffer delays in accessing these tests.  We’re shining a spotlight on the particular challenges and opportunities facing NHS Wales by launching our first ever review of early diagnosis services for bowel cancer in the nation at The National Assembly for Wales.

Early diagnosis saves lives

Early diagnosis of bowel cancer is crucial because the chance of surviving the disease is closely linked to the stage of cancer. In fact, nearly everyone diagnosed at the earliest stage will survive. This chance of survival drops significantly as the disease spreads and develops. Yet in Wales, five out of seven health boards currently breach waiting times for tests that can diagnose bowel cancer. Late diagnosis can negatively affect survival rates. It is shocking that Wales is ranked 25 out of 29 European countries for five year survival rates and just over half (58%) of bowel cancer patients will survive five years or more. Sadly, over half of people are being diagnosed with bowel cancer at the late stage.

Carl from Newport tells us about his experience of delayed diagnosis. “I was referred to a consultant after visiting my GP a number of times. I waited six months to see the consultant and was then put on a waiting list for a colonoscopy. Before this appointment took place, I was admitted to hospital as an emergency where, following further tests and an emergency colonoscopy, I was diagnosed with stage 3 bowel cancer which had spread to the lymph nodes.”

Barriers to detecting bowel cancer early  

So if early diagnosis is so critical to surviving bowel cancer, why are so many people diagnosed at the later stages of the disease when it is less treatable and the chance of survival is lower? Well, our report shows there are significant challenges in Wales around early identification of bowel cancer, including less than optimal screening uptake and a crisis in endoscopy capacity. Both can help to identify and diagnose bowel cancer promptly.

Screening is the best way to diagnose bowel cancer early, but only around half of people eligible to take the bowel cancer screening test actually complete it in Wales. From 2019 Wales have committed to start to replace the current screening test with the faecal immunochemical test (FIT), which is simpler and more accurate. The timely introduction of FIT is vital as it is proven to increase the uptake of screening and cancer detection.

Endoscopy tests can detect cancer at the earliest stage of the disease, when it is more treatable, and even prevents cancer through the removal of pre-cancerous growths (polyps) during the procedures. Timely access to these tests is vital. 

Increasing demand for endoscopy and a lack of capacity in hospitals is the root cause of long waiting times for appointments. The demand for endoscopy has been increasing dramatically over the last few years and further demand will follow with the introduction of the new bowel screening test. It is vital that the Welsh Government and the NHS in Wales create a national endoscopy action plan that projects current and future demand for services and addresses how services can best meet increasing demand.

What happens next?

The launch of our report, ‘Spotlight on bowel cancer in Wales: early diagnosis saves lives’, is supported by Andrew R T Davies AM, Leader of the Welsh Conservatives, Hefin David AM for Caerphilly and Mandy Jones AM for North Wales. We hope that further AMs from all political parties will attend the event and commit to supporting us as an organisation to STOP bowel cancer.

We’re calling on the Welsh Government and NHS Wales to work together to set a timescale and create targets for improvement. We expect Welsh Government to facilitate clear clinical leadership and provide clarity about who is responsible for delivering the improvements needed to deliver better outcomes for patients with bowel cancer.

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We want to hear your story

If you’ve struggled to get access to tests or have been diagnosed late, we’d like to use your story to demonstrate to the Welsh Government and NHS Wales the impact that this can have on everyday lives, and to encourage them to do more to improve outcomes for patients.

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Carl Difford from Newport (pictured above) was on a waiting list for his colonoscopy when he was diagnosed through A&E