World Cancer Day highlights urgency of closing the gap in cancer care

On World Cancer Day (Thursday, 4 February), nine of Australia’s top cancer organisations launch New Normal. Same Cancer to urge the 150,000 Australians who will be diagnosed with cancer this year to speak to their doctors for any new symptoms.

Cancer Australia’s latest report on the COVID-19 impact showed 78,000 (15%) fewer colonoscopies and sigmoidoscopies and 4.3% fewer colorectal surgery procedures from January to September 2020 compared to the same period in 2019.

Bowel Cancer Australia CEO Mr Julien Wiggins told Health Industry Hub “In the middle of the COVID-19 pandemic we could see the impact on patients – treatment was being adjusted, screening was not being done and elective surgeries were cancelled.

“Bowel Cancer Australia initiated and focused its patient awareness campaign from June 2020, during Bowel Cancer Awareness Month, on those who had symptoms – encouraging patients to see their doctor. We were cautious about pushing population screening at a time where patients with a positive screening test were delayed in receiving a colonoscopy. At the height of the pandemic we also experienced a 48% increase in patient enquiries.”

According to Mr Wiggins, AstraZeneca Australia coordinated the New Normal. Same Cancer campaign locally. Bowel Cancer Australia is collaborating with a number of patient-centred oncology advocacy groups* to raise awareness of the impact of COVID-19 on cancer care and call for patients to contact their doctor and return to cancer care services, including anyone who has paused treatment, missed routine checks or is experiencing symptoms that may be due to cancer.

“The biggest reason contributing to the sustained COVID-19 impact on cancer services and procedures results from the suspended elective surgeries in 2020. Even when the restrictions were eased, it wasn’t back to full capacity overnight, it was staged.

“Patient fear of the COVID-19 uncertainty also contributed to Australians wanting to stay safe by avoiding the clinics and their doctors,” said Mr Wiggins.

Patients with cancer were found to be at significantly higher risk for COVID-19 infection and worse outcomes, according to a recent study.

Mr Wiggins commented that delays to cancer screening, diagnosis and management may potentially have serious consequences.

“A recent systematic review and meta-analysis found that a treatment delay of four weeks is associated with an increase in the risk of death. For surgery, this is a 6-8% increase in the risk of death for every four-week delay. This impact is even more marked for some radiotherapy and systemic indications, with a 9% and 13% increased risk of death for definitive head and neck radiotherapy and adjuvant systemic treatment for colorectal cancer, respectively,” he said.

At 35 years of age Gemma, with two young children, found that bowel cancer was the last thing on her doctor’s mind, but she knew something wasn’t right in January 2020.

“A couple of months later I found myself having emergency surgery on my bowel. I then found out I had Stage 3c Bowel Cancer. Shortly thereafter, this was restaged to stage 4 as I had a metastasis on my ovary which was not previously discovered. I just finished 12 rounds of chemo and have had more surgery. It was tough!

“My message to everyone – please present if you have symptoms as they can’t be ignored, and the best chance of survival is getting it early.

“Bowel cancer doesn’t stop because we are in the midst of a pandemic.”

According to the Bureau of Health Information, the number of people in NSW on the elective surgery waiting list in 30 September 2020 was up 11.8% to 95,052, compared with the same quarter in 2019. The median waiting time for non-urgent elective surgery increased to 330 days in July – September 2020, from 240 days the same time in 2019.

“We have to anticipate a catch-up period. Before elective surgery suspension, we already had waiting lists across the public and private hospitals,” noted Mr Wiggins.

“The focus now should be how to clear this backlog to ensure a high quality of patient care continues. I think there needs to be far more creative solutions in the public and private setting to accomplish this.

“The urgency is to eliminate the colonoscopy waitlist. That is the bottleneck in bowel cancer care. Access to radiation therapy, access to surgery, access to the majority of treatments is otherwise mostly within acceptable timeframes.

“It is getting people from the screening test kit or from a symptom, to a GP and then to a timely diagnosis so they have the best chance. We now know that even a treatment delay of four weeks is associated with significantly poorer prognosis,” he concluded.

*The key stakeholders in the New Normal. Same Cancer campaign include Bowel Cancer Australia, GI Cancer Institute, Leukaemia Foundation, Lung Foundation Australia, Lymphoma Australia, Pink Hope, Prostate Cancer Foundation, Ovarian Cancer Australia and Rare Cancers Australia.