Covid-19: Impact on recorded cancer incidence in England

Project summary

The COVID-19 pandemic changed how patients saw their general practitioner (GP) and how healthcare services were delivered in England. GPs were told to see their patients via telephone, video, or online, and rarely face-to-face. Fewer patients went to their GP because of possible cancer symptoms. Cancer testing in hospitals stopped or was limited to people with severe symptoms. In particular, camera testing and imaging were massively reduced. In March and April 2020, only 5 in every 100 camera tests that would normally be done took place. Urgent two-week-wait appointments were down to less than half their normal levels. Bowel, cervical and breast screening services were temporarily paused in March 2020. 

The number of people diagnosed and treated for bowel cancer in England between April and October 2020 was 3,500 fewer than expected. In Northern Ireland, the number of new cancer cases fell by nearly one-quarter – equal to 1,130 fewer people. In Wales, there were 1,011 fewer new cases of breast, bowel and lung cancers than expected, notably in the over-80s and in women aged 50-69 years for breast cancer.

In this project, we will compare the numbers of new cases of 20 cancer types in England after the pandemic began in March 2020 with the expected numbers of diagnoses. Our data source will be copies of electronic medical records in primary care from the Clinical Practice Research Datalink (CPRD). Cancer Registry data for this time are not yet available. Any fall in new cases of cancer suggests diagnostic delay, as we assume those patients will be diagnosed at a later date. Our results will inform the planning and directing of cancer diagnostic resources, by working out if particular cancer types, or particular patient groups (by age, sex, multimorbidity, ethnicity and region) were worst or least affected.