RECENT NEWS REPORTS IN THE UNITED KINGDOM indicate that the COVID-19 pandemic has exacerbated the ongoing problem of lengthy delays in diagnosis of patients within the National Health Service (NHS). This is particularly true of delays for patients waiting on results of their cancer tests.
Currently, approximately 5.3 million patients are on a waiting list in the UK, noted the Policy Exchange, a UK-based think tank, in a report, titled, “A Wait on Your Mind.” The report’s authors determined that 80% of those 5.3 million patients (or about 4.2 million) are “waiting on a decision for treatment [no diagnosis]with an average wait time of 10 months.”
For a better perspective on these numbers, the population of the United Kingdom is 67 million. Thus, the 4.2 million patients “yet to be diagnosed” represent 6.3% of the nation’s total population. For context, if the United States had similar delays, it would mean that almost 21 million of this nation’s 329 million citizens would be waiting for a diagnosis.
The Policy Exchange Report also described how current screening practices within the healthcare system are not capturing cancers early and quickly. “The statistics show that nearly a quarter of cancers—roughly 90,000 cases every year—are detected in patients who are referred on non-cancer pathways.”
In fact, said the report’s authors, “Around a quarter of cancer diagnoses occur following a non-cancer GP [general practice] referral to secondary care. Five times more cancers are detected through this route compared to all screening programs combined. Many of these patients will eventually be diagnosed in hospitals following a long delay, by which point their cancer will now be more advanced.”
The Independent, an online news service in the UK, interviewed Sir Bruce Keogh, former National Medical Director of NHS England, who supports the Policy Exchange’s reports and findings, He said, “Intolerable waiting lists are back. This is our next big test [after the pandemic], both the public and NHS staff have now seen better and expect better.”
A Pathology Think Tank
One factor contributing to lengthy delays in the diagnosis of cancer in the United Kingdom is a shortage of histopathologists. This has been widely reported in the UK during the past three years.
One strategy in response to the shortage of surgical pathologists in the UK is a project to adopt digital pathology on a large scale. The NHS is now creating several regional centers where whole-slide images can be created, allowing these digital images to be more easily distributed to pathologists in different regions.
The expectation is that use of digital pathology systems can make the nation’s histopathologists more productive. This would allow them to increase the number of cases they can diagnose each year and help shorten time to diagnosis.