Emergency diagnosis of bowel cancer needs to stop, we asked clinicians why this is still happening

Bowel cancer is one of the most treatable cancers, especially when caught early. But too many people are ending up in A&E with the disease being diagnosed at a later stage when treatment is more challenging and outcomes are poorer. Around 1 in 4 bowel cancer diagnoses still happen this way, and that figure has stayed stubbornly high for years. We want to understand why, and what can be done about it.

In January we took the first step and published our patient report. We heard directly from people and families who had been through an emergency bowel cancer diagnosis. They described this shocking and devastating experience after repeated attempts to get help and symptoms that didn't point clearly in one direction. 

With the patient perspective more understood, to build a strong case for change, we needed to hear from clinicians too. So, we spoke to GPs, colorectal surgeons, gastroenterologists and clinical nurse specialists to properly understand their perspective. We’ve now published a report into this and held a panel discussion to explore the findings in more detail.

What did clinician’s say about why this is happening? 

Clinicians are clear that

• bowel cancer symptoms can be genuinely hard to recognise 

• GPs are working under enormous pressure with a huge range of possible causes to weigh up 

• for many people, bowel symptoms can be difficult to talk about, and many are unaware of what to look out for 

• even when concerns are flagged, waiting times can be so long that patients deteriorate before they are seen 

Overall, they showed that they’re working hard within a system that is not always set up to catch people in time, and they want to see it improve. 

When people do reach A&E, the experience can be sudden and overwhelming. They may have had little or no warning, and for many, they go from having no diagnosis to facing major surgery within days, with little time to process what is happening or make informed decisions about their care.  

What follows brings its own challenges. Communication breaks down, specialist teams are not always brought in quickly enough, and psychological support is not always there when people need it most. In addition, the emotional toll on clinicians themselves is real and not often spoken about. 

Where clinicians suggest we focus

Clinicians are realistic that emergency diagnosis will never be entirely prevented. Some cancers present suddenly, with little warning. But they are clear it is happening far too often, and that there is more that can be done. This includes: 

• more consistent use of the simple at-home test GPs can offer when patients come to them with symptoms 

• earlier involvement of specialist teams 

• better support after diagnosis  

How do we make change happen?

This work is starting to build a clearer picture of where change is needed. With this we’re building a strong case to make that change a reality. 

Our next step is to take this report further and later this year we’ll be focussing on the evidence and research that’s available, as well as what’s missing.  

We’re working on a campaign to end emergency diagnosis and are ambitious about what can be achieved. You can find out more about the campaign, our next steps and how you can get involved by clicking below. 

• Learn more about Ending Emergency Diagnosis 

• Find out the symptoms of bowel cancer 

• Read the Clinician’s report in full