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COVID-19 death rates fall below cancer death rates for week ending 22 May 2020

Professor Gordon Wishart, our Chief Medical Officer comments on the news that COVID-19 death rates fall below cancer death rates for week ending 22 May 2020. 

  • ONS data confirms deaths from COVID-19 have fallen below cancer death rates for week ending 22 May 2020 – the first time since late March
  • Cancer has not disappeared during the pandemic and there is a growing backlog of patients with undiagnosed and/or untreated cancers
  • Death rates of cancer patients will increase if private hospital resources are not fully utilised during and after the COVID-19 pandemic
  • The NHS and private sector need to work much more closely together nationwide, to deliver urgent access to cancer diagnosis and treatment

June 2020

The COVID-19 pandemic and the UK government’s lockdown response has had a profound effect on access to the diagnosis and treatment of cancer. A study from University College London has estimated there will be up to 18,000 excess deaths in first 12 months of response to the COVID-19 pandemic, due to an observed 70% reduction in GP referrals for early cancer diagnosis as well as a 60% reduction in attendance for chemotherapy1. Professor Richard Sullivan, Director of the Institute of Cancer Policy at Kings College London, recently advised that the number of deaths due to the disruption of UK cancer services is likely to outweigh the number of deaths from the coronavirus itself over the next five years. 

In April 2020, Cancer Research UK estimated that 2,700 patients every week were not being diagnosed during the lockdown, with 2,300 as a result of patients not being referred for investigation of urgent symptoms, and another 400 patients who are not being diagnosed due to suspension of 200,000 appointments every week, for breast, bowel and cervical cancer screening. NHS cancer screening services remain formally suspended in Scotland, Wales and Northern Ireland, and informally paused in England. The number of patients with undiagnosed or untreated cancer is growing week on week and, will directly result in an increased number of cancer deaths and huge anxiety to those patients affected. 

In the week ending 22 May 2020, there were 2589 provisional deaths registered in England and Wales as a result of COVID-19, a decrease of 3,810 from the previous week (ONS). The total number of deaths registered that week was 12,288, still significantly above the 5-year average of 9,040 for that specific week of the year (Figure 1).

Of more interest, however, is that is the first week since the last week of March that the number of deaths from COVID-19 (2,589) has fallen below the average weekly number of cancer deaths (2,795), confirming that cancer has not gone away during the pandemic2. At present, the number of excess weekly deaths seem to be explained by those caused by COVID-19 but, with the increasing backlog of cancer cases, we should expect to see the number of excess deaths due to cancer rise over the coming months.

Although there are signs that cancer services are gradually re-starting, it is likely that the private sector will be required to help treat the backlog of cases as NHS hospitals keep resources free for the potential of a second spike of COVID-19. In fact, there are already signs that the NHS-private partnership will be extended to allow this to happen. There is therefore an urgently requirement to utilise the unused resources in the private sector to diagnose patients with suspicious cancer symptoms and treat all urgent cancer cases if we are to mitigate the rise in cancer deaths, an unintended consequence of the COVID-19 pandemic and lockdown strategy.

Figure 1 

 Figure 1 08 06 20

 

References:

  1. Lai AG, Pasea L, Banerjeee A et al. Estimating excess mortality in people with cancer and multimorbidity in the COVID-19 emergency.

https://www.researchgate.net/publication/340984562_Estimating_excess_mortality_in_people_with_cancer_and_multimorbidity_in_the_COVID-19_emergency?channel=doi&linkId=5ea8b957a6fdcc7050976a3e&showFulltext=true

  1. NOMIS (ONS) 2018 cancer deaths excluding non-melanoma skin cancer.

 

 

 

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