Cancer patients in England are facing record high delays in first-time specialist visits and starting treatment.

Half a million patients with suspected cancer are being forced to wait past the supposed two-week maximum to consult with an oncologist this year, according to the House of Commons Library. The cause is an overworked NHS service that has been stretched to the limit by the COVID-19 pandemic and staff shortages. This has raised concerns about not being able to provide immediate care and a debate on how fast hospitals can clear a backlog of a record six million cases.

Additionally, the number of patients with confirmed diseases who cannot start treatment within the 31 or 62 days that they are guaranteed by the hospital are expected to exceed 75,000 for the first time, according to The Guardian. Experts say that such delays could reduce a patient’s chances of survival, as well as cause them distress and anxiety.

“As this new analysis shows, terrifyingly large numbers of people are waiting longer than they should to receive vital cancer care and treatment with the insecurity of not knowing,” said shadow health secretary Wes Streeting, who was treated for kidney cancer last year.

To help reduce these numbers, the health and social care secretary has requested for research to be conducted to form a new 10-year plan to improve cancer care, speed up diagnosis and invest in effective new treatments.

In 2009, the Labour government introduced new targets for hospitals that in theory were expected to ensure patients received fast and timely care. Steering asked the Commons library to analyze the performance of the NHS against these targets.

In the study, 290,428 people who showed signs of cancer were unable to see a specialist last year between April and November within 14 days of being urgently referred. Among them were 91,896 possibly with breast cancer; 76,307 with suspected skin cancer; and 47,936 who may have had lower gastrointestinal cancer. The proportion of women with suspected breast cancer who were able to see an oncologist within two weeks fell to just 72.7%, the lowest of any recording, according to the study. “Ensuring that women with breast cancer get a prompt diagnosis and start treatment as quickly as possible gives them the best chance of survival,” said Delyth Morgan, the chief executive of Breast Cancer Now.

The figure was higher than the previous record of 235,549 for the full year before and equates to 41,490 people a month who were delayed. As many as 497,877 are projected to miss a first appointment when the 2021-2022 study period is finished at the end of next month. This will be an almost 11-fold rise on the 45,291 cases documented a decade ago.

Additionally, 12,498 people during the first seven months of 2021 to 2022 were unable to undergo their first definitive treatment within 31 days of doctors choosing to treat them. This was higher than the 13,907 in 2020-2021 and could reach 21,425 by the end of March. The figure ten years ago was 4,005.

The figures are worse for those waiting 62 days for their first treatment. Between April and November, 32,647 missed undergoing surgery, chemotherapy or radiotherapy. If this continues, until the end of the next month, a total of 55,966 people will have been affected.

Further exacerbating the situation are delays in the publication of an “elective recovery plan” by the Department of Health and Social Care for addressing the backlog. The publication was delayed for a second time earlier this month due to a disagreement between NHS England and the government over the deadline by which NHS trusts must treat all patients who have waited either one or two years for care, which in most cases is an operation, according to The Guardian.

“There will be an aim to end 104-week waiters by the end of March,” an NHS source told The Guardian. “And nobody will wait more than a year for treatment by March 2025, but the government is trying to bring that forward to March 2024, and that is still being negotiated.”

In addition, the NHS is also facing long waiting lists amid severe staffing shortages that were as high as 100,000 prior to COVID-19. "We have a shortfall of nearly 2000 consultant radiologists, the doctors who interpret complex scans, and we need a long-term plan to solve this; equally, too many scanning machines are out of date, making them slower, less accurate and disconnected from IT systems,” said Dr. Jeanette Dickson, president of the Royal College of Radiologists, in a statement. “IT is a huge problem in the NHS already — systems don’t talk to each other and even logging on can take a doctor valuable time. Finally, we need more consultant oncologists — we’re seeing a shortfall of nearly 20%.”

The number of patients unable to obtain cancer care has risen every year since 2009 when the Labour government created the targets, according to the analysis. In a statement, the DHSC said the pandemic has only made this list grow. It added, however, that most cancer services were back to or above pre-pandemic levels. “Our record investment in the NHS includes an extra £2 billion this year and £8 billion over the next three years to cut waiting times, including through delivering an extra 9 million checks, scans and operations, making sure more patients get the treatment they need sooner.”