UK-wide research to look at impact of Covid-19 on early cancer diagnosis

Researchers at Cardiff University have launched a UK-wide project to investigate the impact of the Covid-19 pandemic on diagnosis of cancer.

The initial message to “stay home, protect the NHS, save lives” and the suspension of cancer screening programmes sent a strong message that “cancer can wait”, said the researchers.

The 18-month research project will look at how these messages have affected people seeking medical help for early signs of cancer or for screening.

Working closely with researchers at Cancer Research UK, King’s College London and the University of Surrey, the study will look at public attitudes and behaviours, exploring key issues that could lead to more cancers occurring or being diagnosed at a late stage.

These may include people dismissing any symptoms as trivial, being reluctant to consult their GP due to fear of catching coronavirus and not taking part in healthy behaviours to reduce the chances of the disease.

The project will share rapid results with NHS, public health agencies and third sector organisations to help create new and relevant public health messaging to combat the issue.

Principal investigator Professor Kate Brain, a health psychologist from Cardiff University’s School of Medicine, said: “The impact of Covid-19 on UK public attitudes towards cancer - translating into delayed referrals, missed screening and late-stage cancer diagnosis - is likely to be considerable.

“From early on in the pandemic the ‘stay home, protect the NHS, save lives’ message, along with the halting of national cancer screening programmes, sent a strong message to the public that ‘cancer can wait’.

“It’s important that we now look at how this has affected people’s attitudes and behaviours to all aspects of cancer - from putting off visiting their GP with worrying symptoms to missed screening.

“We hope our research will help to mitigate any negative effects of the pandemic on cancer attitudes and behaviour.

The researchers are carrying out an online survey of at least 3,500 people over the next two months, and again in about six months time, to ask about recent symptoms, cancer screening and health behaviours during UK lockdown.

The survey will include questions around:

• The time taken to visit the GP with a range of possible cancer symptoms
• Attitudes to cancer screening
• Anxiety about seeking help in the current situation and other barriers to seeking help
• Health behaviours including smoking, alcohol, diet and physical activity
• Preferred ways of receiving public health information

They will also interview around 30 people who took part to understand their attitudes and behaviours in more detail. The survey and interviews will be repeated with the same people six months later to assess any changes in their views and information preferences.

Finally, they will link the survey data with medical records available in Wales to assess the number of GP referrals and tests for suspected cancer symptoms, whether people have taken part in cancer screening, whether people who smoke have quit, and the number and stage of new cancers diagnosed.

“Our study findings will be used to rapidly develop clear public health messages encouraging people to act on the early signs of cancer, take up cancer screening when it becomes available, and engage in healthy behaviours,” said Professor Brain.

“We believe this will help to reduce the negative impact of Covid-19 on cancer outcomes in the longer term.”

Andy Glyde, public affairs manager for Cancer Research UK in Wales, said: “Official figures have shown that the number of urgent referrals for cancer tests in April in Wales dropped to around a third of their normal levels.

"We are extremely concerned about this, as early diagnosis followed by swift access to the most effective treatment remains as important as it’s ever been for cancer survival. We know people have been reluctant to contact their GP during lockdown.

“This research will be invaluable in our understanding of how to give people the confidence to seek help for concerning symptoms, so that we can get cancer diagnosis and treatment back on track.”

The study will be in adults of all different backgrounds and aged 18+ across the UK. It is funded by UK Research and Innovation.