New report on bowel cancer in Wales highlights serious delays in diagnosis and lowest survival rates in Europe

Our new report provides the latest review of early diagnosis services for bowel cancer in Wales. Launched today (Tuesday 6 February) at The Senedd, Cardiff Bay, attended by Andrew R T Davies AM, Leader of the Welsh Conservatives, Hefin David AM for Caerphilly and Mandy Jones AM for North Wales.

The report, ‘Spotlight on bowel cancer in Wales: early diagnosis saves lives’, highlights just over half of patients diagnosed with bowel cancer survive for five years or more (58%), five out of the seven health boards breach waiting times for tests that can diagnose bowel cancer and an alarmingly low number of eligible people take part in the bowel screening programme.

We are calling on the Welsh Government and NHS Wales to work together to set a timescale and create targets for improvements.

Bowel cancer is the fourth most common cancer in Wales. Every year 2,200 people are diagnosed and over 900 people die from the disease, making bowel cancer the second biggest cancer killer. Early diagnosis is crucial because the chance of surviving the disease is closely linked to the stage of cancer.

Nearly everyone diagnosed at the earliest stage of disease (stage 1) will survive, however survival rate drops significantly for those who are diagnosed at the later stages (stage 3 or 4).

Screening is the best way to diagnose bowel cancer early but in 2016 only 53.4% of people eligible to take the bowel screening test in Wales actually completed it. For those that need further hospitals tests via endoscopy, many will wait much longer than the eight week wait target.

Figures released on 18 January 2018 by StatsWales for November 2017 reveal that over 1,800 people are waiting longer than the eight week target set by the Welsh Assembly for colonoscopy or flexi-sigmoidoscopy, which can detect bowel cancer.  Alarmingly, nearly 1,000 of these patients (991) are waiting more than 14 weeks.

Endoscopy tests, such as colonoscopy or flexi-sigmoidoscopy, 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. Therefore 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 a new bowel screening test.

From 2019, Wales will replace the current screening test with a simpler and more accurate one called the faecal immunochemical test (FIT) which has been proven to increase the uptake of screening, but will put more strain on an already overstretched service.

In Wales, endoscopy units in hospitals are struggling to cope with current demand. This means that FIT cannot be brought in at a high level of sensitivity until these issues are resolved. Whilst it has been widely recognised that a timetabled plan is needed to increase the sensitivity level, until this is implemented some cancers will be missed.

Lowri Griffiths, Head of Wales at Bowel Cancer UK and Beating Bowel Cancer, says: “Every day I hear from patients who have experienced symptoms but struggle to be referred for diagnostic tests, or get access to these tests as quickly as possible. I also hear from clinicians who have difficulty coping with the increasing demand placed on services. It is completely unacceptable that Wales has one of the worst five year survival rates in Europe, it must change.

“Our vision is that by 2050 no-one should die from bowel cancer and to ensure that happens, shining a spotlight on earlier diagnosis is critical.

“Many strategies to improve cancer outcomes have been written in Wales. What we need now is action. We have put together a number of recommendations calling on the Welsh Government and NHS Wales to work together to set a timescale and create targets for improvements.”

Bowel Cancer UK and Beating Bowel Cancer commissioned the report to highlight the scale of the problem that patients and clinicians face, which if address could ultimately improve patient care and survival rates. The report also comes after the death of Sam Gould, a political campaigner, from Penarth, Wales. He was diagnosed with stage four bowel cancer in April 2017 at the age of 33 and died a few months later.

Just after his diagnosis Sam shared his experience with the charity: “Like most men, I tend to discount concerns about my health, but I developed a lot of pain and was bleeding when I went to the toilet. I realised that I could have bowel cancer, but at first the doctor thought I was too young and put me on a 30 week waiting list for a hospital appointment, rather than the urgent cancer referral list which was two weeks long.

“After pleading with the endoscopy department for any cancellation, I was able to get a quicker appointment, which confirmed that I did have cancer. The diagnosis was a terrible shock for me and my family, my wife Caroline and our three children, Olivia, Louisa, and Pippa.”

• Read our blog on the key findings of the report and how you can show your support.
• Read more about how we plan to tackle the endoscopy crisis in our Right test, Right time campaign
• Find out more about our work in Wales
• Sign up as a campaign supporter and help us to improve early diagnosis
• Share your experiences of delayed testing that could diagnose bowel cancer