Almost 20,000 prostate cancer diagnoses missed because of Covid pandemic

Almost 20,000 diagnoses of prostate cancer may have been missed during the pandemic, research suggests.

The study by the University of Surrey and the University of Oxford, which analysed 24 million patient records since 2020, shows the devastating impact of the Covid pandemic on the detection of other major killer diseases.

Researchers said “unprecedented disruption” in the diagnosis of cancer – with a drop in urgent referrals from GPs, longer waiting times and difficulties accessing care – could mean tens of thousands of men have missed diagnoses which could save their lives.

Scientists analysed prostate cancer incidence between January 2015 and July 2023, using a database that covers 40 per cent of the English population.

They found a 31 per cent drop in diagnoses of prostate cancer in 2020, with 4,722 fewer diagnoses than would be expected.

The following year saw 3,148 fewer diagnoses than normal – a drop of 18 per cent.

While diagnosis rates returned to expected levels in 2022, this left 7,940 fewer diagnoses in the previous two years – meaning 19,800 fewer cases when extrapolated across the country.

The estimates in the study, published in BJU International (formerly known as the British Journal of Urology) compare with previous estimates of 14,000 missed diagnoses during the pandemic.

Separate research has shown that death rates among men with prostate cancer tripled during the first year of the pandemic.

Prof Pat Price, a leading oncologist and chairman of the charity Radiotherapy UK, said: “This is shocking data and shows the worsening situation we have been warning about in cancer.

“Sadly when these 20,000 men are eventually diagnosed they could have more advanced disease and need more treatment. 

“NHS leaders have not sufficiently increased cancer treatment capacity in response to the backlogs and so more and more people will need to wait longer for their cancer treatment.

“Tragically, it does not have to be this way. The Government needs a dedicated cancer plan to help this recovery, reduce treatment waits and save lives.”

The study also identified peaks in mortality from prostate cancer during the two most stringent lockdowns.

During April 2020 prostate cancer-related mortality went from 5.5 to 8.5 per 100,000, with a second peak in January 2021 of 7.5 per 100,000.

Six months older

The study also found that men who were diagnosed with disease in 2021 were on average around six months older than those before the pandemic – suggesting crucial time lost in diagnosis and treatment while disease was spreading.

When prostate cancer is caught in the first two stages, survival rates are close to 100 per cent.

But they drop to around 50 per cent for those treated at stage four.

Lead author Dr Agnieszka Lemanska, senior lecturer in health data science at the University of Surrey, said: “Understandably, during the pandemic, resources and attention in healthcare systems shifted towards preventing and managing the virus. 

“This was to the detriment of other areas of the health service including cancer care.

She said: “Early cancer diagnosis is key to improving cancer-related outcomes and long-term survival. It is important that we learn the lessons from the pandemic. However, to do this, we need to fully understand the scale of how services and diagnosis rates were impacted during this time.”

Separate research has shown that death rates among men with prostate cancer tripled during the first year of the pandemic. 

The figures show almost 5,000 extra deaths of men with prostate cancer during the pandemic – at a time when the number of diagnoses fell. Only around 1,000 were caused by Covid, researchers said.

That study of NHS hospital data by charity Prostate Cancer UK found alarming changes in diagnosis and treatment of the disease, with cases spotted far later, when the disease is less treatable.

Cancer operations fell more in Britain than almost anywhere else in Western Europe during the pandemic’s first year, international research shows. In total, the number of prostate cancer operations fell by more than 40 per cent in 2020, against an OECD average of 16.6 per cent.

The study by the Organisation for Economic Co-operation and Development (OECD) shows how efforts to “protect the NHS” from Covid meant cancer operations were reduced on a far greater scale than in other countries.

The international study, which compared 25 OECD nations, examined four common procedures for treatment of cancer and other health conditions in 2019 and 2020. It shows that for each of them Britain reduced surgery levels on a scale seen by almost no other country in Western Europe.

Much routine surgery was stopped during the early stages of the pandemic, with cancer patients among those who saw operations cancelled.

GP care access

Meanwhile, difficulties accessing GP care fuelled delays in diagnosis, meaning thousands more patients are now coming forward, often at a far later stage of disease.

Chiara De Biase, of Prostate Cancer UK, said: “The pandemic brought huge challenges to the NHS and to every one of us. As this important research outlines, one major consequence was that thousands of men didn’t come forward for prostate cancer testing.

“To find these men, we launched a major campaign with the NHS in 2022, and created our online risk checker which enables men to quickly find out their risk of getting prostate cancer and what to do about it. 

“The risk checker has now been used more than 2 million times, and referral rates across the UK have risen above pre-pandemic levels.”

An NHS spokesman said: “While fewer people came forward for cancer checks during the pandemic, the NHS has been working hard to encourage people to get checked and more recent data shows the total number of men diagnosed with prostate cancer since March 2020 has now overtaken the number we would have expected to see diagnosed during this period. 

“The NHS is seeing and treating record numbers of people for cancer, and it is vital that people come forward if they are concerned about unusual symptoms – getting checked early saves lives.”

A Department of Health and Social Care spokesman said: “We are committed to improving outcomes for prostate cancer and in November we joined with Prostate Cancer UK to unveil a £42 million screening trial to find ways of speeding up its detection. 

“The NHS has seen and treated record numbers of cancer patients over the last two years and cancer is being diagnosed at an earlier stage, more often, with survival rates improving across almost all types, including prostate cancer. 

“We have invested £2.3 billion into speeding up diagnosis, launching 154 Community diagnostic centres across England and we will build on our progress through our forthcoming major conditions strategy.”