King Charles' cancer diagnosis causes uptick in GP visits

And why current cancer waiting times are the worst on record...
09 February 2024

Interview with 

Naser Turabi, Cancer Research UK


Cancer cells


It was announced this week that King Charles III is stepping back from his Royal duties as he undergoes treatment for cancer. It has not been disclosed what type of cancer Charles has, but it was discovered when he was being treated in hospital for an enlarged prostate. Meanwhile, BBC News analysis has revealed that cancer waiting times for 2023 in England were the worst on record. Naser Turabi is director of evidence and implementation at Cancer Research UK...

Naser - At the moment in the UK the results have just come out. For the last year, for 2023, about 65% of people have met the target, which is to wait about two months from urgent referral to their treatment. The target is actually 85%, so that means 20 percentage points off that. And what that means is that obviously people are waiting too long for treatment, but the longer you wait for treatment and the later a cancer is diagnosed, the more likely it is to progress, and the further a cancer progresses, the harder it is to treat. So what we find, for example, in bowel cancer is that cancer is detected at an early stage, 95% of people survive for at least five years, but if cancer is detected at a late stage when it's spread to other parts of the body, only about 15% of people survive five years.

Chris - So the early bird catches the worm, it really matters here, doesn't it? Those numbers that you are citing in terms of the wait times, they have crept up inexorably year on year. Why is that? Why are we waiting longer?

Naser - Yes, you are right. We haven't met that target since about 2015. And the main reason we haven't is because the NHS doesn't have enough capacity to do the diagnostic tests and to do the treatment that's required. Investment in diagnostics - that means scanners, that means radiologists who interpret the scans, that means pathologists who diagnosed the tissue samples, oncologists and surgeons. We don't have enough of those essentially. And it takes a long time to train those people and we haven't invested enough over the last 10 or 15 years in doing that. But what we actually are also seeing is that we have an ageing population and that cancer is in fact predominantly a disease of older people. So there are much higher numbers of people aged over 70 and the shape of our population is changing over time and we have a much older population than we did even just 10 years ago and so the demand is increasing. We've got about 30% more urgent cancer referrals than we did in 2019. So we're seeing an increase in demand, but not enough increase in NHS capacity.

Chris - Has that bulge in terms of an ageing population also changed the types of cancer that people are presenting with? Historically, we thought about prostate cancer in men, lung cancer overall across the population, bowel cancer, bladder cancer, as very common cancers. Are we seeing that distribution change because the population's ageing or, we just got more of it?

Naser - I think generally we're just getting more of the same cancers. What we are seeing, and it's positive, is increasing early stage diagnosis for some cancers, particularly the ones where we've got screening programs in place. So for bowel cancer, for cervical cancer and for breast cancer, those screening programs are really successful at finding early stage cancers. And similarly for cervical cancer, what we're actually seeing is the HPV vaccine, is having the effect to prevent cancer. So younger people, fewer younger people are getting cervical cancer.

Chris - And in terms of what's happened with King Charles, when a high profile person goes public with a diagnosis like this, does that make a difference? Do more people go and see doctors either with disease and get picked up earlier? Does it help and do you also see more worries? Well, so you've got a higher risk of saturating the system. There must be two sides to this coin.

Naser - So we absolutely do see an uptick in presentation by the public when celebrities go public on having cancer. So we saw that with Jade Goody for cervical cancer. We saw it with Stephen Fry for prostate cancer. We saw it for Angelina Jolie when she announced she was having a preventative mastectomy. Last year Dame Deborah James died, and that caused a big uptick in the level of bowel cancer referrals and broadly speaking, these are really positive. There is a small concern that you might stimulate people who are just worried, but often if you've got symptoms, you do need to go to your GP anyway. And so it's really about your GP, going to your GP, making sure they can make the decision. And the most important thing, and actually often the longest delay is when people are sitting at home with symptoms or received a screening invitation letter but haven't acted on it. So anything that helps people to seek help we think is positive.

Chris - Are there any MOT type tests that you would advocate if you are a man in his mid to late fifties for example, or a woman of a similar vintage, are there any things where you're thinking, I would advise those people if they can to go and get tested for the following things and does that have merit doing that?

Naser - Going and getting tested when you don't have symptoms of things is quite a complicated issue. And so what we would definitely recommend at Cancer Research UK is that if you are eligible for the national screening program, so bowel, cervical and breast, you absolutely should consider taking up that invitation. It's not compulsory, but you absolutely should consider that because those are very likely to find cancers at an early stage. Other than that, actually you should make sure that you are aware of the signs and symptoms of cancer. So that can be unexplained weight loss blood in your poo or urine, and there are many others and you should go to our website and check it out, all the NHS websites. But generally these sorts of general health mots aren't that helpful for cancer.


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