COVID-19 pandemic had significant impact on bowel cancer diagnosis and treatment, new report finds

The COVID-19 pandemic caused a significant drop in bowel cancer diagnoses, a new report for England and Wales has found. Over 4,000 fewer people were diagnosed with the disease in the first year of the pandemic compared to the previous year, because of a significant drop in urgent referrals for suspected cancer and the pausing of screening programmes.

The latest annual report by the National Bowel Cancer Audit (NBOCA) – which we're a member of – also found the pandemic had a negative impact on bowel cancer treatment, with nearly half of patients (47% compared with 29% pre-pandemic) not having their ileostomies reversed within the recommended period of 18 months. This potentially affects peoples' quality of life. There were also fewer patients receiving chemotherapy following surgery for bowel cancer (57% in 2020 compared with 61% in 2019).

Findings from the NBOCA audit are published annually, measuring and comparing outcomes across diagnosis, treatment, and care for more than 30,000 bowel cancer patients across England and Wales. The audit makes recommendations to health bodies to enable them to understand where variations in care exist across the bowel cancer pathway, and where key improvements can be made.

The 2022 report – the thirteenth to date – includes data on patients diagnosed with bowel cancer between Wednesday 1 April 2020 and Wednesday 31 March 2021, so the data and findings therefore cover the initial period of the COVID-19 pandemic, when services were most severely affected.

The report comes as the latest NHS waiting time figures for England (November 2022) show that while more people are being referred for diagnostic tests, less than half (49%) of patients were given a rule out or diagnosis of bowel cancer within the 28-day target from urgent referral. This emphasises the urgent need to address staffing issues within the NHS, as leaders admit they will not be able to meet their target to get waiting times back to pre-pandemic levels by March 2023.

Disruption during the pandemic also interrupted an otherwise upward trend in early diagnosis of bowel cancer. The proportion of patients diagnosed at an early stage was at 38% (down 2% from the previous year). But this is still lower than the overall picture for all cancers, where more than half (55%) are diagnosed at early stages (stage 1 and 2) in England, and far behind the Government ambition of 75% of all cancers to be diagnosed early by 2028.

Genevieve Edwards, Chief Executive at Bowel Cancer UK, said: "This report clearly underlines the devastating impact the pandemic had on services that were already struggling, exacerbating existing problems in the NHS including waiting times.

"We know that bowel cancer is treatable and curable, especially if it's diagnosed early. While it's positive to see in the NBOCA report that there's a general upwards trend for early diagnosis, we need to move much faster to reach the target of 75% early diagnosis by 2028.

"Staff in the NHS are working tirelessly to diagnose and treat bowel cancer patients, but we can't fix the problem without addressing the longstanding shortage of staff trained in endoscopy and pathology. The Prime Minister must urgently address this in the 10-year Cancer Plan to meet the ambition to diagnose 75% of cancers early by 2028."

We're one of a group of stakeholders, including members of the public, charities, primary and secondary care clinicians, who submitted a response into the Department of Health and Social Care's call for evidence in April to inform a new 10-year Cancer Plan, sharing the views of our patient and clinical community. We're still awaiting the publication of the new plan which we expected in 2022.

• Find out more about our campaign to increase early diagnosis of the disease
• Knowing the symptoms of bowel cancer could save your life
• Take action on our campaigns to help us improve early diagnosis and access to best treatment and care for all those affected by bowel cancer