July 21, 2024

The NHS must concentrate on the basics of cancer treatment rather than the “magic bullets” of new technology and artificial intelligence, or risk the health of thousands of patients, experts have warned.

In a paper published in the journal Lancet Oncology, nine leading cancer doctors and academics say the NHS is at a tipping point in cancer care with survival rates that are behind many other developed countries.

Since December 2015, the NHS has failed to meet its target of 85% of cancer patients starting treatment within two months. International research shows that every four weeks delay in treatment increases the risk of death by up to 10%. That means hundreds of thousands of people must wait months to start essential cancer treatmentand only 67% start treatment within 62 days.

The paper highlights 10 pressure points that contribute to entrenched cancer survival disparities, delays in diagnosis and treatment, and inappropriate care.

In a starkly worded warning, the cancer experts say “new solutions” such as new diagnostic tests have been wrongly hyped as “magic bullets” for the cancer crisis, but “none address the fundamental issues of cancer as a systemic problem”.

A “common fallacy” of NHS leaders is the assumption that new technology can reverse inequalities, the authors add. The reality is that tools like AI can “create additional barriers for those with poor digital or health literacy”.

“We caution against technocentric approaches without robust evaluation from an equity perspective,” the paper concludes.

Ajay Aggarwal, the paper’s lead author and a consultant oncologist and professor of cancer services and systems research at the London School of Hygiene & Tropical Medicine, said while no one was suggesting the NHS should stop investing in new technology, is not necessarily going to improve it. patients’ predictions.

“The discussion around AItechnology, liquid biopsies, is slightly reductionist as a solution to cancer care,” he said. “AI is a workflow tool, but is it actually going to improve survival? Well, we have limited evidence of that so far. Yes, it’s something that could potentially help the workforce, but you still need people to take a patient’s history , to take blood, to do surgery, to preach bad news.”

Instead, the focus should be on patient care, he added. “Without early diagnosis, good quality treatment, good survival and follow-up, we are talking about avoidable deaths.”

The UK government should “concentrate on improving the basics of cancer care”, said Prof Pat Price, a co-author of the paper and oncologist, who is a visiting professor at Imperial College London and the charity’s chairman. Radiotherapy UK.

“We must ensure timely treatment as well as prompt diagnosis. If you boost diagnosis but don’t treat people in time, the newly diagnosed patients just get stuck on long waiting lists. Unless the NHS focuses on tackling these challenges, thousands of patients could die prematurely.”

The authors reiterate calls for a cancer control plan that introduces measures to ensure more patients are treated within 62 days of referral for suspected cancer, improved screening rates, a national cancer workforce strategy, better mental health support for cancer patients and a task force to tackle. the social and commercial determinants of cancer, such as housing quality, food policy, alcohol and smoking.

In 2022, the government announced that a 10-year cancer plan for England. The policy was controversially abandoned less than a year later, when cancer was absorbed into a main condition strategy. Experts have warned patients would die as a result, point to research showing that dedicated cancer policies are associated with excellent five-year survival outcomes.

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And in May, the then chairman of the Commons Health and Social Care Select Committee, Steve Brine, wrote to the then health secretary, Victoria Atkins, to inform her that the committee’s future cancer research concluded that “it is a mistake to abandon the 10-year cancer plan” and called on the Department of Health and Social Care (DHSC) to reintroduce it.

Responding to the Lancet paper, Mark Lawler, a professor of digital health at Queen’s University Belfast, said: “Cancer care needs to be put firmly back at the top of the political agenda; it could save thousands of lives a year – which could be more important than that?

“Without a dedicated cancer plan, cancer patients will die.”

Cancer Research UK’s director of evidence and implementation, Naser Turabi, said the report highlighted the investment and reform needed in all aspects of cancer care.

“Cancer patients deserve more, and change will not be possible without a long-term, fully funded strategy for cancer research and care.” The new government must deliver on its promises and give cancer services the much-needed additional staff and equipment they need, he added.

A department of Health and Social Care spokesperson said: “Too many patients are waiting far too long to be diagnosed and treated. The NHS has fewer diagnostic scanners per person than other countries and many of these are older machines.

“Early diagnosis and treatment are essential to defeating cancer. By doubling the number of MRI and CT scanners, and buying AI-enabled scanners that diagnose faster, we will get sick earlier and save lives.”

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