What data from the pandemic can tell us about the challenge ahead in 2023 for early diagnosis.

Since COVID-19 hit, Breast Cancer Now has been voicing concerns about its impact on breast cancer diagnosis, in particular, diagnosis at an early stage, when treatment is most likely to be successful. 

During the first few months of the pandemic, visits to the GP about possible breast cancer symptoms dropped significantly. There was also a significant interruption to the UK’s breast screening programme, which finds a lot of breast cancers at an early stage.  

Since 2020, we have been estimating the shortfall in breast cancer diagnosis due to the pandemic, but we now have official 2020 statistics from NHS England, Scotland and Northern Ireland. While this data doesn’t include Wales or cover 2021 and 2022, it does paint a much clearer picture of how the pandemic disrupted breast cancer diagnosis. 

The fall in breast cancer detection

Across all regions, significantly fewer women were diagnosed with breast cancer in 2020, versus 2019. 

UK Nation  Drop in female breast cancers diagnosed in 2020, vs 2019            Percentage decrease   
England 8,220 17%
Scotland 535 11%
Northern Ireland 111 8%

There was an even bigger decrease in the diagnosis of ‘ductal carcinoma in-situ’ (DCIS) breast cancers, as shown below. DCIS is a very early form of cancer that isn’t yet able to spread into the surrounding breast tissue.  

UK Nation  Drop in female DCIS breast cancers diagnosed in 2020, vs 2019         Percentage decrease   
England 2,368 32%
Scotland 180 36%
Northern Ireland 22 10%

The decline of early stage diagnosis

As well as showing a decline in breast cancer detection overall, the statistics show a dip in the rate of early, stage 1 and 2, breast cancer diagnosis. This is in sharp contrast to the years leading up to the pandemic, where early diagnosis rates were increasing.  

  • In England, the percentage of breast cancers detected in early 2020 fell by 3% from the year before (from 86% to 83%). Overall, around 5,500 fewer people were diagnosed early in 2020, compared to 2019.  
  • In Scotland, early diagnosis declined from 88% in 2018 and 2019 to 86% across 2020 and 2021.
  • In Northern Ireland, between April and December 2020 81% of breast cancers were diagnosed early, down from 84% (2018 and 2019 average).

What does all this mean?

These figures show just how much COVID-19 disrupted breast cancer diagnosis in the UK, especially early diagnosis. The Welsh government are yet to publish their figures, but it’s highly likely these will show a similar disruption. 

Some of the 2020 trends, like the drop in GP referrals for suspected breast cancer, have since been reversed. However, pandemic disruption and the slow recovery of services has had a lasting impact on the speed of breast cancer diagnosis.  Breast Cancer Now estimates that there are still thousands of people across the UK with undiagnosed breast cancer because of COVID-19. 

The decrease in early diagnosis in 2020 is also a cause for alarm, as breast cancer patients have the highest chance of survival when the cancer is found early. Whilst we need to wait to see the long-term impact of the pandemic on cancer survival, we are profoundly concerned that the decline in early diagnosis in 2020 could lead to increasing breast cancer mortality rates in years to come. 

What are we doing?

Breast Cancer Now is deeply concerned about the long-term impact of the pandemic on breast cancer diagnosis, and it’s our mission to make sure breast cancer is detected as early and as quickly as possible. 

Screening  

So, this year, one of the key issues we’re focused on is the breast screening programme, and how we can maximise the number of breast cancers found early through screening. This will form the next stage of our No Time To Waste campaign, which was launched in parliament last year, to push for faster and earlier breast cancer diagnosis. 

In Scotland, we are working with the NHS to develop their ‘Equity in Screening Strategy’, to make sure breast screening is easily accessible to everyone who’s eligible. We’ll also be working with our partners in the Wales Cancer Alliance, to ensure screening services are prioritised in the Welsh government's upcoming five-year cancer plan.  

Waiting times  

We know that waiting for a possible breast cancer diagnosis is a scary and uncertain time. That is why we will continue to track waiting times across the UK and push for ambitious standards on rapid diagnosis and timely access to treatment.    

Workforce  

Good diagnostic services depend on having the right workforce in place. In 2023 , we will be continuing our work, in coalition with other cancer charities, to make the case for fully-funded long-term workforce planning in every part of the country. 

Family history  

In 2023, we’re also supporting new projects  aiming to identify more women at an increased risk of developing breast cancer, due to genetics or family history, and provide them with additional support to improve their chances of an early diagnosis. All at-risk women should have access to the right screening for them based on their risk level, and we will be advocating for equal access to comprehensive at-risk screening across the UK.  

How can you help?

We’re always looking for personal stories and experiences from people who have been affected by breast cancer to help shape our policy and campaign work. If you have a breast cancer diagnosis story that you would like to share with us, please get in touch: campaigns@breastcancernow.org.