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Bowel cancer services face their toughest challenge

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Genevieve Edwards

Chief Executive, Bowel Cancer UK

The COVID-19 pandemic has had a huge impact on bowel cancer services, with nearly 100,000 people in England alone waiting for crucial diagnosis tests.


Over 42,000 people are diagnosed each year with bowel cancer. Yet, sadly around 16,500 people die from the disease each year, making it the second biggest cancer killer. But this shouldn’t be the case. Bowel cancer is treatable and curable, if diagnosed early.

The COVID-19 pandemic continues to have a significant impact on cancer services. The most concerning has been nearly an eight-fold increase, compared to pre-pandemic levels, in the number of people in England waiting longer than six weeks for a colonoscopy – a test which is crucial for diagnosing bowel cancer.

Many of those waiting for an endoscopy test won’t be diagnosed with bowel cancer, but we know that almost a quarter of bowel cancer patients are diagnosed every year through this routine GP referral.

Reshaping bowel cancer diagnosis

Prior to the pandemic, bowel cancer survival in the UK was improving and had more than doubled in the last 40 years. Yet, we still lagged behind international counterparts, so as we emerge from the pandemic, we have an opportunity to innovate and do things differently.

We know screening is the best way to diagnose bowel cancer early, when curative treatment is more likely.

Right now, a new procedure known as colon capsule endoscopy is being piloted as an alternative to colonoscopy. It is a capsule, no bigger than a large vitamin pill, that a patient swallows which contains small cameras that take pictures to look for any problems or signs of disease. This can help the NHS prioritise those who urgently need further tests. 

More resources are urgently needed

Frustratingly, staff shortages continues to be the biggest barrier to improving earlier diagnosis and meeting commitments in NHS England’s Long Term Plan. A lack of endoscopy and pathology staff is preventing the UK from having a world-leading bowel screening programme. We know screening is the best way to diagnose bowel cancer early, when curative treatment is more likely. It can also prevent it by identifying and removing polyps (non-cancerous growths) that may develop in cancer.

With a growing ageing population, the capacity crisis is only going to become more urgent, as more people will need to be referred for tests. To improve bowel cancer outcomes and meet the Government’s ambition to diagnose 75% of all cancers at an early stage by 2028, they must act now by using this year’s Spending Review to provide multi-year funding to train more staff, and provide more equipment in cancer diagnostic and treatment services to meet current and future demand.

For more information visit: bowelcanceruk.org.uk

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