Giant footprints appear on UK beach, representing tens of thousands of cancer patients at risk of becoming the ‘Forgotten C’ amid the coronavirus pandemic
A series of almost 100 pairs of gigantic footsteps have filled a coastal bay in the seaside town of Scarborough, representing the tens of thousands of people in the UK who Macmillan Cancer Support estimates have not yet had their cancer diagnosed as a result of disruption to cancer services and fewer people seeking medical care during Covid-19.
The charity is releasing the powerful series of pictures and a film of the giant footprints being created and washed away at high tide today, to represent the ongoing risk of cancer becoming the ‘Forgotten C’ amid the coronavirus pandemic.
The 190 footprints — each measuring in at a colossal 6 metres in length and which took over 12 hours to carve — extended for over 1 kilometre across the length of Cayton Bay in Yorkshire.
Commissioned by Macmillan Cancer Support, the striking installation was created to coincide with the publication of a new report by the leading cancer charity. The Forgotten C? The impact of Covid-19 on cancer care today reveals that as many as 50,000 people in the UK have cancer which has not yet been diagnosed because of the disruption caused by Covid-19[i].
Worryingly, the new report further reveals that the number of those with undiagnosed cancer could double by this time next year if cancer referrals and screening do not catch up. This would leave 100,000 people at risk of being diagnosed late and having a lower chance of survival[ii]. The charity is warning that the pandemic has created a backlog of undiagnosed cancer which could take a further 18 months just to tackle in England alone in a best-case scenario[iii].
Lynda Thomas, Chief Executive at Macmillan Cancer Support, said:
“These footprints represent the tens of thousands of people who are yet to hear the life-changing news that they have cancer, and those who are having their appointments disrupted once again. It is simply unacceptable if these people face unbearable and unprecedented delays which could see their hopes for the future washed away.
“Cancer doesn’t stop for Covid-19 and neither can our health services. Macmillan is doing whatever it takes to support people with cancer and our exhausted NHS staff, but we need more. Governments need to promise every person with cancer that they won’t be forgotten and ensure cancer services are protected, come what may.”
To prevent the situation worsening, Macmillan is calling on governments across the UK to guarantee that NHS cancer services will have ringfenced staffing and resources to keep running this winter — preventing redeployment of equipment, beds, or cancer nurses and clinicians; and guaranteeing access to the Covid testing and protective equipment needed. To clear the backlog, Macmillan has called for cancer service recovery plans to show how NHS services will get the additional resources needed to meet increased demand, and to boost support for burnt-out NHS cancer teams.
Anyone worried about delays to treatment or diagnosis can call the Macmillan Support Line on 0808 808 00 00, which is open 7 days a week, 8am-8pm. Those who are experiencing cancer symptoms should visit their GP as a matter of urgency.
-ENDS-
NOTES TO EDITORS
The full report is available here.
Link to full suite of imagery for download here.
FACTBOX
In the new report, Macmillan experts map out a series of scenarios and outcomes which estimate that:
· If cancer screening and diagnosis returns to normal, with 10% additional NHS capacity compared with before the pandemic, it would still take until April 2022 to clear the current cancer backlog in England[iv]. A similar analysis, though not directly comparable, shows it could take around three years to clear the backlog in Wales[v]
· If cancer screening and diagnosis returns to normal, but with no additional capacity, there would be more than 50,000 more people in the UK with undiagnosed cancer than before the pandemic at any one time[vi]
· If cancer screening and diagnosis does not recover to pre-pandemic levels, every month there will be an additional 4,000 missing cancer diagnoses in the UK — adding up to a colossal 100,000 people in the backlog by October 2021[vii]
Macmillan also commissioned a large-scale survey of people with cancer in the UK in the summer of 2020[viii]. This shows that:
· More than 650,000 people with cancer in the UK[ix] (22%) have experienced disruption to their care because of Covid-19, including tests or treatment being delayed, changed or cancelled. This figure is likely to include many thousands of people who may not be in active treatment but still require follow up care and support following an earlier cancer diagnosis
· For around 150,000 people (5%) this included delayed, rescheduled or cancelled treatment. Of these, more than half (57%) told us they were worried that delays to their treatment could affect their chance of survival
· Half (50%) of all those currently having cancer treatment experienced disruption such as delays, changes or cancellations including:
o More than one in four (29%) currently having treatment have had at least one test, scan or treatment delayed or rescheduled
o One in 13 (8%) have had to travel to a different hospital than usual for their care
o One in 17 (6%) have had a test, scan or treatment cancelled
o One in six (17%) have had to go for a test, scan or treatment on their own against their wishes
· And a further 90,000 people living with cancer in the UK[x] (3%) had not experienced disruption to their care, but had experienced possible symptoms of their cancer getting worse or coming back and had not yet told their GP or healthcare team because they’re either scared of catching the coronavirus or they do not want to add to the current pressure on the NHS
[i] Macmillan Cancer Support. The Forgotten C? The impact of Covid-19 on cancer care. October 2020. Link to follow.
[ii] Macmillan estimates the gap in activity leading to patient diagnosis in England by considering expected number of diagnoses through each route (Public Health England: Routes to Diagnosis. Available from: http://www.ncin.org.uk/view?rid=4194) and applying year-on-year differences in activity reported for the two-week wait (see ii), GP appointment attendance (Appointments in General Practice — August 2020, NHS Digital), Emergency admissions (A&E Attendances and Emergency Admissions 2020–21. Adjusted: Monthly A&E Time series September 2020, NHS England) and Macmillan’s estimates of screening activity. For Wales estimates we examined the number of patients entering the Single Cancer Pathway each month compared to a June 2019 to February 2020 baseline (Cancer Waiting Times — Monthly, StatsWales). For Northern Ireland we examine the year-on-year difference in number of patients with a pathology sample indicating cancer (Recent trends in the Number of Patients with Pathology Samples Indicating Cancer: August Update, NICR). For Scotland we take an incidence-weighted average of gaps in activity observed in England, Wales and Northern Ireland. We estimate a UK-wide gap of around 50,000 diagnoses between March and August 2020 with a gap of 4,000 cancer diagnoses at latest point of data reporting (July for Northern Ireland; August for England and Wales) which would lead to a total of 100,000 fewer diagnoses by October 2021 if this gap was sustained.
[iii] Macmillan’s analysis of cancer waiting times figures: Two Week Wait From GP Urgent Referral to First Consultant Appointment, NHS England. Cancer Waiting Times — National Time Series Oct 2009 –August 2020 with Revisions. We identify 343,000 fewer people seeing a cancer specialist following urgent referral between March and August 2020 compared to this period in 2019. This gap has improved each month from May to August and we estimate that if activity levels continued to improve each month until it reached and remained at 10% above 2019 levels then it would take until April 2022 to reduce the 343,000 backlog to 0.
[iv] As per ref ii
[v] Macmillan’s analysis of cancer waiting times figures: Number of patients entering the single cancer pathway, StatsWales. We identify a 31% gap between the number of people entering the pathway per working weekday between March and August 2020 compared to a baseline period of June 2019 to February 2020. This gap has improved each month from May to August and we estimate that if activity levels continued to rise each month at the rate of most recently observed improvement until it reached and remained at 10% above baseline levels then it would take until September 2023 to reduce the accrued backlog to 0. A smaller level of improvement observed between July and August accounts for the extensive length of recovery in this scenario. We acknowledge that differing methodology in calculating backlog for England and Wales means direct comparison between the nations is inappropriate.
[vi] As per ref iii
[vii] As per ref iii
[viii] Macmillan Cancer Support/YouGov survey of 2,202 adults with a previous cancer diagnosis. Fieldwork was undertaken between 2nd — 15th June 2020. The survey was carried out online. The figures have been weighted and are representative of all UK adults 18+ who are living with cancer according to age, gender, cancer type, and UK nation.
[ix] % figures from ref viii, rounded to the nearest %, were applied to the estimated 3 million people living with cancer in the UK. 3 million figure is derived from 2013 complete prevalence (Macmillan-NCRAS Cancer Prevalence Project). This is projected forwards using the UK growth rates in Maddams et al. (2012), resulting in an estimated 3 million people living with cancer in the UK. This includes all people who have ever had a cancer diagnosis, some people in this group may no longer consider themselves to be living with cancer.
[x] As per ref viii
