Britain’s shameful cancer treatment times putting our lives at risk

When Sarah started having chest pains in early June 2021, her first port of call was her GP. She was otherwise healthy, 30 years old and busy juggling work and raising her son in Manchester. “My GP had a feel of my chest area and said it seemed as though I had an inflamed sternum. I had never heard of it,” Sarah says. 

Her doctor asked if she had been doing anything physically strenuous. She told him she had recently moved house but it was “nothing out of the ordinary”. 

“Oh, that will be it. You just need to rest but it can take six to eight weeks to resolve,” he told her. 

Soon she found herself struggling to say more than two to three words without pausing to catch her breath. Her GP again reassured her. Concerned, Sarah insisted on an X-ray. She was told it would be four weeks. In desperation, she went to A&E. Again, “they just really dismissed me. They made me feel as though I was wasting their time. I saw a doctor and he told me don’t bother going for the chest X-ray, it will be a waste of time,” she says.

If Sarah had listened to him, she could well be dead now. On September 6, three months after her first GP visit, she finally received her diagnosis: lymphoma, a blood cancer. 

Sadly, Sarah’s story is not unusual. In Britain, cancer patients struggle to get diagnosed and treated quickly. Partly as a consequence, more people die from cancer relative to the population in the UK than in other rich countries, at 222 in every 100,000 per year. In Japan this figure is only 175, the US 182 and Germany 206. 

A Telegraph reader last year shared what such figures can mean on a personal level.

Upon retiring in Morbihan, France, at 69, his local doctor immediately ran a blood test that revealed gout. Meanwhile, treatment for polyps in the intestine revealed an enlarged prostate and kidney stones.  

“My wife had a similar experience with breast cancer. She thinks that if we had stayed in Peterborough health authority, we would both be dead. We are still waiting for the breast scan they took of her in Peterborough Hospital years ago,” he said. 

Sarah, on the other hand, is still haunted by the missed opportunities that left her having to explain to her five-year-old son why mummy’s hair is gone.

At some point in their lives, half of Britons will, like Sarah, be told they have cancer. Now, shockingly, the King and the Princess of Wales have joined their number. 

“What people do not realise, and this is exactly what happened with the King,” says Richard Sullivan, director of the Institute of Cancer Policy and a professor at King’s College London, “is that 45 to 50 per cent of our cancers are picked up incidentally.” King Charles was diagnosed with an undisclosed form of the disease during an examination for an enlarged prostate. 

Internal cancers – like something in your gut, bowels or bladder – can emerge with few obvious symptoms. Often they are only discovered during a procedure for something benign: “Whilst you are having an operation we will use a video camera and have a look at the lower gastrointestinal tract. You would be surprised how many times we then pick up an early-stage cancer that is just sitting there growing quietly,” Sullivan says. 

Delays in detecting and treating cancer can be deadly – especially in younger people. “If you get cancer in your 20s and 30s it is almost invariably really aggressive because it has managed to escape all the biological mechanisms that keep it suppressed,” says Sullivan. 

Speed of diagnosis is critical. The risk of death from common cancers grows by six to 13 per cent for every month of delayed treatment, research by Sullivan and others has found. A woman with breast cancer faces a 25 per cent greater chance of dying if her treatment is delayed by three months. If all British women suffering from breast cancer faced this delay in a year, there would be 1,400 preventable deaths.  

Yet Britain’s record on early detection is poor. “We are not doing well,” says Peter Sasieni, one of Britain’s leading experts on cancer screening, prevention and early diagnosis. “The standard is to compare how long people live after being diagnosed with cancer. Amongst comparable countries the UK typically comes worst,” he says. 

The reasons are often obvious. Patients up and down the country struggle to get seen by their GP, then face waits for diagnostics and more waits for treatment. “In England, it has been some time since the NHS has met key targets,” says Sarah Scobie, acting director of research at the Nuffield Trust. “Around 40 per cent of people are waiting for more than two months from referral to start treatment. The target is 15 per cent. It was last met in 2015,” she says.

In 2018, the Government announced that three-quarters of all cancers would be diagnosed at an early stage by 2028. Only four years away, little progress has been made to meet the deadline: “There has been barely any change in the proportion. It is currently around 59 per cent,” Scobie says. The NHS is “not keeping up with the demand and the need for cancer treatment,” is her verdict.  

Meanwhile, the number of patients waiting more than three months to receive cancer treatment after a GP has referred them urgently has climbed to a record high. In 2023 some 23,416 cancer patients waited more than 104 days, close to a tripling from 9,025 in 2019.

“The biggest issue is the ability of GPs to order tests that work and get them done quickly,” says Sasieni. “Typically, what happens is that people go with symptoms that are not obviously cancer, but [where] cancer is one of many possibilities,” he adds. “People can have mild symptoms. It would really help if we had more tests that a GP could order without having to refer the patient to the hospital, which is where there seems to be a big holdup,” he says. 

“Once they get that referral then there is how quickly the hospital or secondary care can do it. There have been huge strains, particularly since Covid, for getting diagnosis made quickly,” Sarsieni adds. 

Indeed, the legacy of the pandemic is still visible in Britain’s cancer statistics. Close to 40,000 fewer people were treated for cancer in 2020 across the NHS. There has been a catch-up effect since with a record rise in treatments last June, but The Telegraph’s analysis suggests there are still 7,000 “missed” cancer treatment starts.

Today, Telegraph analysis of NHS figures shows that three in four hospitals fail to meet the requirement for all patients to start treatment within one month, creating a deadly postcode lottery. 

In December, three in ten cancer patients at the Sherwood Forest Hospitals NHS Foundation Trust had to wait more than a month to start their treatment. In contrast, not a single patient at the Countess of Chester Hospital faced this wait.  

“People have to appreciate that if there is something wrong with the general NHS and it as a whole is super delayed with treatments and diagnostics for routine conditions, it will have a massive impact on cancer as well,” Sullivan warns. 

The impact of near-record NHS waiting lists has spurred a rise in desperate Britons going private. Figures from the Private Healthcare Information Network show a record rise in such treatments in the first half of 2023. 

Cancer treatments make up nearly a quarter of the private hospital market in London, accounting, at £378 million, for a quarter of revenue. This means people are often either paying thousands of pounds out of pocket or relying on their employer to provide medical insurance.  

Many companies, however, are put off by the complexity and costs associated with providing such insurance, says Caroline Laffey at KPMG. This is because health benefits are often taxable, meaning both the company and the employees face additional costs. “It is an absolute minefield,” says Laffey. As a result many employers avoid them. 

The British Chambers of Commerce (BCC) is urging the Government to provide tax breaks like reducing insurance premium tax. “The pressures on the NHS are widely known,” says Jane Gratton, deputy director at the BCC. “Employers have a role to play – not only in promoting good health but in supporting the people they have invested in.”

Politically, the pressure to tackle shameful cancer figures is also growing. “We are concerned that there is not a dedicated cancer plan,” says Conservative MP Steve Brine, who leads the Health and Social Select Committee. “I think that is a mistake and the evidence around the world shows that it will be.” 

Former health minister Lord Bethell is frustrated with the situation too. The capacity for screening in terms of diagnostic capacity and workforce is far too small, he warns. “We catch far too many cancers at stage three or four when it has much worse outcomes, fewer limited treatment choices and costs a lot of money.”  

For Sarah, delay in treatment came at great personal cost. In some regards she counts herself lucky: after gruelling treatment she was finally given the all-clear a year and a half ago. But, she says, the impact on her mental health is still “really, really challenging”. 

“It felt like such a fight to get to get heard. Now I have had six rounds of chemotherapy and then radiotherapy and the effects are just massive,” she says. Her consultant said she would have been offered the chance to freeze her eggs in case she wanted more children – but there was just not enough time.  

“When he had that conversation with me that something has to be done now, it finally hit me how precious the time was to get the treatment started,” she says. “I just remember thinking if this had been caught earlier then I might have had that opportunity.”