Denise Campbell         September 23, 2014 

Doctor and mammogram

Almost half of people who get cancer are diagnosed late, which makes treatment less likely to succeed and reduces their chances of survival, Cancer Research UK warns on Monday.

In a report, the charity claims that 46% of all patients with cancer in England have their disease diagnosed when it has already reached an advanced stage.

The findings have highlighted the worryingly high rates of late diagnosis, and consequently poor survival, for people with many types of cancer in Britain and prompted calls for heavier NHS investment in renewed efforts to spot the disease more quickly.

Although the situation has improved in recent years, Britain still has one of the worst records in Europe for both identification of cancer and survival from it.

Urgent improvements to how soon cancer is diagnosed would save the NHS tens of millions of pounds a year through reduced chemotherapy, radiotherapy and surgery, as well as enhancing many cancer sufferers' chances of survival, CRUK estimates. Currently some areas of England are between three and five times better at detecting certain forms of cancer than others and that variation needs to be reduced, it said.

The charity's research found that 46% of all cancers diagnosed in England in 2012 were not detected until they had reached stage three or four, according to its analysis of data collated by the NHS's National Cancer Intelligence Network.

Overall, 93% of cases of melanoma (skin cancer) were diagnosed at stage one or two, as were 83% of those found to have breast cancer and 61% of prostate cancers.

However, only 23% of lung cancer cases were found at an early stage, as were 32% of cases of non-Hodgkin lymphoma and 44% of ovarian cancers.

"Once a cancer has spread, it is often harder to treat successfully, meaning that a person's chances of surviving are much lower.""Diagnosing cancer at its earliest stages, before it has had a chance to spread to other parts of the body, can have a huge effect on survival", said the charity.

For example, if lung cancer is diagnosed early, seven in ten patients will live for at least a year but only one in four do so when it is detected late. Likewise, with bowel cancer, nine in ten patients survive for at least five years when they are diagnosed early but fewer than one in ten do so when the disease has reached stage three or four upon identification.

Late diagnosis can occur when a patient delays going to see a doctor about symptoms they have developed, or a doctor wrongly judges those signs to be of no concern or believes they indicate another illness, such as irritable bowel syndrome.

Some cancers, such as pancreatic cancer, often only become noticeable once they have begun to spread, said Sara Hiom, CRUK's director of early diagnosis. However, "for many others there are chances for the cancer to be picked up earlier", she added.

Anyone who notices something unusual about their body should visit their GP at once. "GPs play a critical role of course, knowing when symptoms need to be investigated and referring patients promptly for tests," she said. CRUK estimates that, if all parts of the NHS diagnosed cancer as promptly as the best ones do, then the service could save as much as £210m a year and improve 52,000 patients' chances of survival across the 200 different types of cancer.

For example, a case of ovarian cancer detected at stage one or two costs the NHS an average of £5,328 to treat, whereas one detected at stage three or four is £15,081, the report says. Similarly, a colon cancer patient detected early typically costs £3,373 while one not identified until a later stage is much more – £12,519.

In 2012, some 331,487 people were diagnosed with cancer across the UK and about 162,000 people died. Men are a third more likely to die than women.

The report "provides a compelling case for substantial investment in efforts to achieve earlier diagnosis", said Harpal Kumar, the charity's chief executive.

"Earlier diagnosis saves lives and it could save critical NHS funds. And in the face of an overstretched NHS and a projected growing number of cancers diagnosed in the years ahead, we need to do everything we can to ensure that all patients have access to the best treatment as early as possible", he added.

The Department of Health said it had invested £450m to improve earlier diagnosis, including giving GPs better access to tests such as CT and MRI scans.

"Cancer survival rates continue to improve but we want to be the best country in Europe for cancer diagnosis and treatment. Last year GPs referred nearly half a million more patients to see a cancer specialist than 2010 and we did a record 1.5m diagnostic tests," said a spokeswoman.

Jeremy Hunt, the health secretary, is so concerned by the failure of GPs to spot cancers that he is developing a plan which reports have said could see GP surgeries "named and shamed" for mistakes.

Dr Sean Duffy, NHS England's national clinical director for cancer, said: "We are working closely with Cancer Research UK to support the NHS to improve outcomes for patients through earlier stage diagnosis.

"The NHS is successfully seeing 50% more patients than four years ago and survival rates have never been higher. Almost nine out of 10 patients say their care is excellent or very good."

This article was amended on 22 September 2014. An earlier version omitted the word "often" in reporting a comment from the director of early diagnosis at Cancer Research UK that some cancers were often only noticeable once they had started to spread.