Fiona Hazell, chief executive of Leukaemia UK, says that the National Cancer Plan must commit to earlier diagnosis targets for leukaemia.
As World Cancer Day approaches, the publication of the government’s long-awaited National Cancer Plan for England represents a defining moment for cancer care. The plan has the potential to transform outcomes for patients for years to come, but only if it reflects the realities of all cancers.
Blood cancers are the fifth most common cancer type in the UK, impacting hundreds of thousands of people, and are the third biggest cause of cancer deaths. There are 60,000 people in the UK who are currently living with a leukaemia diagnosis alone.
However, they have been consistently overlooked in a system designed around stageable, solid tumours. Unlike tumours, blood cancers cannot be staged, and as a result, they are excluded from current early diagnosis targets and performance measures. No national cancer policy to date has focused on monitoring progress in early diagnosis for leukaemia and other blood cancers.
At Leukaemia UK, we have been campaigning for the government to recognise the unique challenges faced by people with leukaemia and other blood cancers in the National Cancer Plan, and to take urgent action to stop them devastating lives.
Avoidable delays
As leukaemia and other blood cancers cannot be treated surgically, they often require immediate and aggressive treatment, meaning early diagnosis of the disease is vital to give people the best chance of survival. However, a recent study commissioned by Leukaemia UK found that one-in-four leukaemia patients in England currently experience an avoidable delay in their diagnosis – resulting in worse outcomes for patients and avoidable costs for the NHS.
Many people who present with the signs and symptoms of leukaemia experience a delay in escalation at the GP level. We speak to patients every day whose leukaemia symptoms were initially missed, often on multiple occasions. Those who do have their symptoms escalated often face delays in being referred for a full blood count test, which can rule leukaemia in or out, due to capacity issues in phlebotomy services.
Currently, 37% of leukaemia cases are diagnosed in emergency settings such as A&E, far higher than the cancer average of 21%. This significantly impacts the effectiveness of treatment, prognosis and survival rates for patients.
For those diagnosed with Acute Myeloid Leukaemia (AML), a particularly aggressive form of the disease where symptoms escalate rapidly, this impact is stark. One-year mortality for AML patients diagnosed in an emergency setting is 67%, compared to 48% for those diagnosed in a non-emergency setting. Reduction of leukaemia emergency diagnosis will both save lives and ease some of the pressures on the NHS.
Half of the people currently diagnosed with leukaemia in the UK won’t survive for more than five years. Even more alarmingly, if no action is taken, nearly 80% of those diagnosed with AML today will not survive until the end of this parliament. This is simply unacceptable, particularly when we know five-year survival rates are higher in several European countries, and when progress has been made for other common cancers.
At Leukaemia UK, we hear stories every day from patients and their families highlighting the devastating consequences of a delay in diagnosis. As the National Cancer Plan is finalised, the government has a once-in-a-generation chance to change this and commit to increasing survival and improving the lives of those with leukaemia. This can only be done with a focused commitment to earlier diagnosis, faster pathways, and policies that truly reflect the realities of blood cancer.
Meaningful policy change needed
A recent response from the Department of Health and Social Care confirmed that it shares these concerns about existing early diagnosis targets and recognises there is more to be done to improve outcomes for non-stageable cancers such as leukaemia. They are also considering the feasibility of adopting new metrics to track progress for non-stageable cancers as part of the upcoming plan.
This is encouraging, but for the thousands of people living with leukaemia and those yet to be diagnosed, it is now vital that this recognition translates into meaningful policy change. The National Cancer Plan must introduce a new early diagnosis metric for non-stageable cancers so that blood cancers are no longer excluded from national targets.
It must also commit to practical, evidence-based solutions that we know can make a difference, including a commitment to faster referral for a full blood count test, clearer guidelines for escalation and better follow-ups to help diagnose leukaemia earlier and reduce emergency diagnosis. A best-practice timed pathway for leukaemia would ensure that anyone with an abnormal full blood count is seen by a specialist within one week.
With a focused commitment to better diagnosis, treatment and care, it is possible to increase survival and improve the lives of those with leukaemia. We are ready to work with the government and all those with the power to drive change, to move towards a future where leukaemia and other blood cancers no longer devastate lives.
