Too many people are at risk of becoming “martyrs” by not getting symptoms of cancer checked out because they do not want to burden the NHS, warns a report, which calls for earlier testing to diagnose those at higher risk.
The report, by the health consultancy Incisive Health, sets out ways in which the NHS in England can catch more cancers early and thus save lives by becoming more of an “early intervention service”. It comes as the government draws up its first dedicated cancer strategy since 2015.
Evidence has shown that a desire not to “bother” a GP is more common among those with potential signs of cancer in the UK than in other countries. Between a fifth and a third of people in Britain would not want to waste the doctor’s time.
Cancer specialists have urged people with symptoms such as fatigue, bleeding and weight loss to get investigated urgently, so they can start treatment sooner if they do have it.
Failure to act quickly helps to explain Britain’s dismal record, by international standards, in diagnosing cancer early. Although cancer survival has risen, the UK still lags behind other countries in identifying cases early, despite initiatives to encourage people to act on symptoms more promptly.
“People shouldn’t be discouraged from going to their doctor if something doesn’t feel right for them. They aren’t ‘bothering’ their GP or ‘burdening’ the NHS,” said Naser Turabi, Cancer Research UK’s director of evidence and interpretation.
Overcoming reluctance to seek help is vital if Britain is to diagnose more cancers at stages one and two, before they have spread, and when they are more curable, the report says. It was written by Incisive’s Mike Birtwistle , who interviewed doctors, senior NHS personnel and key figures in cancer in his research.
“No one wants people with symptoms of cancer to become martyrs due to holding off seeking medical attention because they didn’t want to bother their GP or overload the NHS. Too many people avoid seeking help because they know how stretched the NHS is,” said Birtwistle.
“This kind of martyrdom to protect the NHS results in too many people being diagnosed at a late stage, damaging their survival chances.”
The NHS should be “mobilising people with signs and symptoms” of cancer, the report says. “There should also be a continued role for raising public awareness of signs and symptoms and – most importantly – motivating them to act. Experts highlighted that people are often conditioned not to ‘bother’ the NHS.”
It highlights that GPs can also discourage patients from having a check-up because they do not want to add to the strain on already pressured hospitals. “Primary healthcare professionals have a role in previously guarding NHS resources, which can act as a deterrent for seeking help.”
Studies have found that Britain takes longer than many other countries to diagnose cancer. Survival rates are up to 25 years behind those in other European countries and lives are being lost as a result, Macmillan Cancer Support analysis found last year.
The number of people in the UK being diagnosed with cancer every year has risen to about 412,400 – one every 90 seconds – due to the ageing population and lifestyle factors such as obesity and alcohol. About 167,000 people die a year – 460 a day – from what is Britain’s biggest killer after heart disease.
The NHS has consistently failed to meet a target to diagnose 75% of cancers at stages one and two between 2018 and 2024, with only 60% spotted by then, the report reveals.
But it could increase early detections by:
Offering prostate cancer screening to men at higher risk of the disease, including black men and those with a family history or specific genetic mutations.
Extending lung cancer checks to people who have been exposed to passive smoking or live in areas of high pollution.
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Assessing people for pancreatic cancer who have been diagnosed with diabetes and lost weight.
Extending liver health checks, which are already offered to some people at higher risk of liver cancer and provided at GP surgeries, homeless shelters and sexual health clinics.
Assessing the health of the oesophagus (food pipe) in people who have taken drugs that tackle stomach acid, called proton pump inhibitors, as that can increase the risk of oesophageal cancer.
The government should use its forthcoming ten-year health plan and the cancer plan to embed a more proactive approach to cancer detection in the NHS, Birtwistle said.
But the NHS should focus on improving attendance rates for its three cancer screening programmes – for breast, bowel and cervical cancer – before introducing screening initiatives that may not be based on good evidence, Turabi said.
Hospitals should offer more convenient appointments, more online booking and an at-home testing kit to those who have shunned an offer of cervical screening, he said.
Sarah Woolnough, the chief executive of the King’s Fund thinktank, said: “There’s strong evidence that finding cancer early leads to better treatment and survival, so we should redouble efforts to make community access to prevention and early detection services as easy and convenient as possible.”
The NHS was diagnosing and treating more early-stage cancers than ever, when the chances of a good outcome were higher, said Prof Sir Stephen Powis, NHS England’s national medical director. About 7,300 people a year are being diagnosed at stage one or two than before the Covid pandemic.
“There are many reasons why people are reluctant to come forward and get checked, from not recognising the key signs and symptoms of cancer to not wanting to burden the NNS unnecessarily,” Powis said.
The health service is improving early diagnosis through approaches such as offering lung checks to smokers and ex-smokers in hi-tech mobile scanning trucks in supermarket car parks, Powis added. They have led to thousands of people being diagnosed earlier than would otherwise have happened.
