The NHS must focus on the basics of cancer treatment rather than the ‘miracle cures’ of new technologies and artificial intelligence or it will put the health of thousands of patients at risk, experts have warned.
In a paper In a report 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 lagging behind those of many other developed countries.
The NHS has missed its target of getting 85% of cancer patients started on treatment within two months since December 2015. International research shows that every four-week delay in treatment increases the risk of death by up to 10%. This means hundreds of thousands of people are having to wait months to start essential cancer treatment, and only 67% Start treatment within 62 days.
The article highlights 10 bottlenecks that contribute to persistent inequalities in cancer survival, delays in diagnosis and treatment, and inappropriate care.
In a sharply worded warning, the cancer experts say that “new solutions” such as new diagnostic tests have been wrongly touted as “miracle cures” for the cancer crisis, but that “neither solution addresses the fundamental problems of cancer as a systems problem.”
A “common misconception” among NHS leaders is the assumption that new technologies can reverse inequalities, the authors add. The reality is that tools such as AI “can create additional barriers for people with poor digital or health literacy”.
“We caution against technocentric approaches without robust evaluation from an equity perspective,” the article concludes.
Ajay Aggarwal, the paper’s lead author, an oncologist and professor of cancer services and systems research at the London School of Hygiene & Tropical Medicine, said that while no one was suggesting the NHS should stop investing in new technology, this would not necessarily improve patients’ prognosis.
“The discussion around AI, technology, liquid biopsies“Is slightly reductionist as a solution for 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 can potentially help the workforce, but you still need people to take a patient’s history, draw blood, perform surgery, deliver 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 preventable deaths.”
The UK government should “focus on improving the basic principles of cancer care”, said Prof Pat Price, co-author of the paper and an oncologist, visiting professor at Imperial College London and chairman of the charity Radiotherapy UK.
“We need to ensure timely treatment and rapid diagnosis. If you increase diagnosis but don’t treat people in time, newly diagnosed patients simply end up on long waiting lists. If the NHS doesn’t focus on addressing these challenges, thousands of patients could die prematurely.”
The authors reiterate their call for a cancer control plan that includes measures to ensure more patients are treated within 62 days of referral for suspected cancer, improve screening rates, establish a national cancer workforce strategy, provide better mental health services to cancer patients, and establish a taskforce to address the social and commercial determinants of cancer, such as housing quality, food policy, alcohol and smoking.
In 2022, the government announced a 10-year plan for cancer for England. The policy was controversially abandoned less than a year later, when cancer was included in a key conditions strategyExperts warned that patients would die from this, pointing to research which showed that a specific cancer policy was associated with better five-year survival outcomes.
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And in May, the then chair of the House of Commons Health and Social Care Select Committee, Steve Brine, wrote to the then Health Secretary, Victoria Atkins, informing her that the committee future cancer research had 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 the plan.
In response to the Lancet article, Mark Lawler, professor of digital health at Queen’s University Belfast, said: “Cancer care needs to be put back at the top of the political agenda. It could save thousands of lives every year. What could be more important than that?”
“Without a specific cancer plan, cancer patients will die.”
Naser Turabi, director of evidence and implementation at Cancer Research UK, said the report highlights the investment and reform needed across 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 extra staff and equipment they need, he added.
A Department of Health and Social Care spokesperson said: “Too many patients are waiting far too long for diagnosis and treatment. 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 beat cancer. By doubling the number of MRI and CT scanners and buying AI scanners that diagnose faster, we can detect diseases earlier and save lives.”