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NHS putting patients at risk by not testing 41% of cancers

Thousands of cancer patients are missing out critical molecular diagnostic tests in NHS hospitals, new research by Cancer Research UK revealed today (20 August).

Analysing data from last year, the organisation found that over 24,000 tests were not undertaken – representing a 41% gap from the demand of nearly 60,000 tests.

Around 16,000 eligible patients with non-small cell lung cancer or colorectal cancer also missed out on testing, therefore wasting their chances to explore all possible treatment options.

And around 3,500 of these patients would have been eligible of targeted medicine, thus missing out on relevant benefits – such as avoiding side effects or increasing chances of survival.

Emlyn Samuel, senior policy manager at Cancer Researcher UK, said: “Thousands of patients are missing out on tests entirely, some of whom may have gone on to receive a targeted medicine that could have helped them. This is a longstanding issue that needs to be rectified urgently.

“It’s extremely worrying that patients are missing out on routinely available treatments, simply because they are not being given a test to see if they might benefit from them.”

Molecular diagnostic tests are used to identify genetic mutations in a patient’s cancer to help doctors work out the best treatment for them, including different types of chemotherapy and targeted drugs.

For patients with targetable cancers, accurate treatment can extend their lives by months or years.

Tests can also save the NHS money, by avoiding prescribing drugs that won’t work for certain patients.

Two of the most significant causes for the gap in testing identified by the organisation were lack in funding and poor awareness of targeted medicine among clinicians and multi-disciplinary teams.

Cancer UK recommended that NHS England should make greater funding available to support testing now and in the future, ensuring all eligible patients have access to tests.

They also said commissioning these diagnostics in the NHS should be coordinated at national level, including by developing policies to ensure equal access to high quality tests with speedy results. Policies should be flexible enough to let labs move from individual tests to panel-based tests.

Samuel said: “The 2011 cancer strategy for England recommended a national approach to both funding and providing molecular diagnostic tests. Along with others, we have been frustrated that little progress has been made.

“Our report estimates that such an approach will cost around £13m per year. That will both fill the gap in the number of tests provided, and create a national service that is set up for the future, when more tests will be needed for more targeted medicines.

“And let’s not forget that this will also help research, by making it easier to identify patients for clinical trials.”

However he noted that all suitable patients with melanoma are receiving tests, an “impressive fact from which “important lessons” could be learned.

But he added that this is likely because the number of patients with advanced melanoma is relatively small compared with lung and bowel cancer, and tests were paid for by the pharmaceutical company that makes the targeted drug instead.

He also owes the success to an “enthusiastic clinical community” that exists in skin cancer to keep this testing up.