Early diagnosis and timely treatment: Why both are key to improving cancer survival
David Long, Business Unit Director for Oncology
| MSD
The government and NHS’s positive action on early diagnosis must be matched with an equal focus on timely treatment if we are to deliver a step change in cancer survival. David Long, Business Unit Director for Oncology at MSD UK, explains how current NHS pressures need not be a barrier to patients receiving the right treatment at the right time.
The government and NHS have an ambition that, by 2028, 55,000 more people each year will survive their cancer for at least five years.1 This will require collaboration across the healthcare system to drive improvements at every stage of the patient pathway. Welcome progress has been made on early diagnosis 2 but, if this is to translate into increased survival, we must place equal emphasis on accelerating time to treatment – so that everyone, everywhere, gets the care they need without delay.
The NHS is assessed on how quickly it treats cancer patients via the 62-day target. This states that at least 85% of patients should start treatment within 62 days of an urgent referral for suspected cancer.3 Achieving the target has proved challenging in recent years,4 but the NHS is working hard to reach 70% by March 2024,5 up from the current level of 62.8%.6 This is vital because even short treatment delays can increase mortality,7 not to mention that waiting for treatment is often an anxious time for patients.8
MSD is proud to partner with patient groups, professional bodies and the NHS to address some of the UK’s biggest cancer challenges. We have 40 collaborations with the NHS planned or underway and, based on our experience, we believe that returning to – and exceeding – the 85% threshold as soon as possible can be achieved by bringing people together to explore new ways of planning and delivering treatment.
For example:
Accelerating patient pathways – MSD has developed a Pathway Development Programme (PDP), which supports the NHS to optimise cancer pathways. Working collaboratively, with Oxford University Hospitals NHS Trust on a PDP, we redesigned the lung cancer pathway to reduce the time from urgent referral to diagnosis by an average of 15 days, and the time from first chest x-ray to treatment by an average of 16 days.9
Increasing treatment capacity – through a series of Capacity Workshops across the country, we are helping NHS staff to free up resources so that more patients can receive optimal cancer treatment. In one case, an NHS Trust and Cancer Alliance were able to start offering adjuvant therapy to potentially up to 140 patients a year. Previously, they had been unable to provide this treatment option.
Speeding up biomarker testing – in Wales, we worked with Aneurin Bevan Health Board to accelerate the diagnostic pathway for head and neck cancer patients. Together, we helped reduce the time it takes to process biomarker test results from 40 to 13 days, enabling patients to receive the most appropriate therapy for their specific form of cancer as quickly as possible.10
With the right political will and collaboration, we believe these approaches could be adopted and scaled quickly, without putting undue pressure on already stretched cancer services. This will only become more important as cancer cases continue to rise11 and as advances in science lead to an expansion of treatments which are effective in the earlier stages of many cancers.12,13
Ultimately, the benefits of early diagnosis will not be realised without greater focus on timely treatment. MSD will continue to support the NHS in any way we can, and we urge collective focus from all in the system – including the NHS and government – on ways we can improve time to treatment for every cancer patient.
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1 NHS England. NHS Long Term Plan ambitions for cancer. 2019. Available from: https://www.england.nhs.uk/cancer/strategy/. Accessed October 2023
2 NHS England. Earlier diagnosis. Available from: https://www.england.nhs.uk/cancer/early-diagnosis/. Accessed October 2023
3 NHS England. Cancer waiting times review – Models of care and measurement: consultation response. 2023. Available from: https://www.england.nhs.uk/publication/cancer-waiting-times-review-models-of-care-and-measurement-consultation-response/. Accessed October 2023
4 Nuffield Trust. Cancer waiting times. 2023. Available from: https://www.nuffieldtrust.org.uk/resource/cancer-waiting-time-targets. Accessed October 2023
5 NHS England. Changes to cancer waiting times standards from 1 October 2023. 2023. Available from: https://www.england.nhs.uk/long-read/changes-to-cancer-waiting-times-standards-from-1-october-2023/. Accessed October 2023
6 NHS England. Provider-based Cancer Waiting Times for August 2023 - 24 (Provisional). 2023. Available from: https://www.england.nhs.uk/statistics/statistical-work-areas/cancer-waiting-times/monthly-prov-cwt/2023-24-monthly-provider-cancer-waiting-times-statistics/provider-based-cancer-waiting-times-for-august-2023-24-provisional/. Accessed October 2023
7 Hanna, T.P. et al. Mortality due to cancer treatment delay: systematic review and meta-analysis. BMJ. 371:m4087. 2020. Available from: doi: 10.1136/bmj.m4087. Accessed October 2023
8 Macmillan. What Are We Waiting For? Act now on long cancer waits. 2023. Available from: https://www.macmillan.org.uk/dfsmedia/1a6f23537f7f4519bb0cf14c45b2a629/11925-10061/what-are-we-waiting-for-english. Accessed October 2023
9 MSD. Oxford Respiratory Early Diagnosis Service (REDS) Lung Cancer Pathway Development Project (PDP). Available from: https://www.msd-uk.com/partnerships/collaborative-working/. Accessed October 2023
10 MSD. Aneurin Bevan University Health Board Head and Neck Pathway Development Programme (PDP). Accessed November 2023. Available from: https://www.msd-uk.com/partnerships/collaborative-working/
11 Cancer Research UK. Cancer in the UK: Overview 2023. 2023. Available from: https://www.cancerresearchuk.org/sites/default/files/cancer_in_the_uk_report-overview-03.pdf. Accessed October 2023
12 Bai, R. et al. Neoadjuvant and Adjuvant Immunotherapy: Opening New Horizons for Patients with Early-Stage Non-small Cell Lung Cancer. Frontiers in Oncology. 10:575472. 2020. Available from: doi: 10.3389/fonc.2020.575472. Accessed October 2023
13 Topalian, S.L. et al. Neoadjuvant checkpoint blockade for cancer immunotherapy. Science. 367(6477):eaax0182. 2020. Available from: doi: 10.1126/science.aax0182. Accessed October 2023
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