Not a euphemism for talc on you fanny right
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Hard read; we were mugs
As early as November 2020, the potential impact of the Covid pandemic on cancer treatment was already beginning to cause grave alarm. More than 300,000 planned screenings, it was then reported, had not taken place because testing services had either been reduced or suspended altogether in the months since the crisis had struck in March of that year.
The National Screening Service, testing for breast, bowel and cervical cancers, had planned to screen more than 433,000 people in 2020. Instead, the pandemic lockdowns had left them up to 70% behind their targets. Consultant oncologists were so concerned about the screening backlog that they launched the Care Can’t Wait campaign in late 2020.
A reduction in services due to the pandemic meant that, even when patients turned up with worrying symptoms, it simply wasn’t possible to provide all the tests they needed as quickly as they needed them.
‘The last thing patients need to hear is that we’d like you to get this scan,’ Dr John Crown said at the time, ‘but we can’t do it for a month.’
A combination of missed or delayed screenings, along with a significant decline in the number of people presenting with cancer worries for fear of going anywhere near a hospital during the worst of the pandemic, the consultants warned, was likely to cause serious problems in cancer care in the years ahead.
It now looks very much as if those fears have come to pass.
In the first year of the pandemic alone, around 2,600 cancers went undetected, either because people didn’t attend screenings or didn’t go to their doctors to have worrying symptoms checked out. As a result, the Oireachtas Health Committee heard this week, patients are turning up in hospitals with far more advanced cancers than would otherwise be expected – because they simply didn’t get seen in time.
This figure, remember, relates to just the first year of the pandemic – a period of nine months – since the effects of the lockdown would not have been felt until late March of 2020.
We won’t know until later this year, it seems, just how the figures shaped up for 2021 and 2022, but if the missed diagnosis rate remained at around one in ten, the 2020 figure provided to the committee, the numbers are likely to be far worse.
To add to the misery, said Irish Cancer Society chief executive Averil Power, those now presenting with advanced symptoms arrive into the hospital system at the worst possible time. Emergency departments have reported record numbers on trolleys since the beginning of the year and, said Ms Power, ‘it’s terrifying to think you have to go through an overcrowded ED to get access to care’.
It’s pretty terrifying, anyway, to think that people whose cancers should have been picked up for life-saving early treatment over the past three years have been walking around unaware that they were in mortal danger.
Was it really wise, in hindsight, to sacrifice the care and screening of one potentially fatal disease in our panicked haste to contain another? It was not, after all, as if the threat of the other Big C somehow receded during Covid. Should more effort have been made to maintain cancer services as a priority, back when we were being warned that reduced services were simply a warehousing of misery to come?
Early diagnosis of many common cancers, after all, is the best way to save lives – and, in the process, health service resources. If colorectal cancer is caught in time, for example, there’s a 95% chance that the patient will survive for at least five years. But if the same disease is diagnosed later, that five-year survival rate falls to just one in ten.
The upshot of the pandemic’s impact, Oireachtas members were told, is that instead of being picked up in routine screening or identified by an alert GP, some 14% of cancers are now being diagnosed in emergency departments. Imagine the awful anxiety, the hours of waiting, the vanishing hope that the bleeding or the lump or the sudden pain is something trivial… The tragic reality behind that statistic doesn’t need spelling out.
Once your cancer is bad enough that you need emergency treatment, it’s bad. Imagine getting that most dreaded news after a night on a chair in a chaotic ED.
‘A delayed cancer diagnosis is not a statistic,’ as Averil Power told politicians this week. ‘It is a whole world collapsing.’