Pandemic may have long-lasting impact on blood cancer survival, warn parliamentarians

March 9, 2022
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A cross-party group of MPs is urging the government to ensure that blood cancer services are equipped to recover from the pandemic.

The All-Party Parliamentary Group (APPG) on Blood Cancer and the APPG on Stem Cell Transplantation and Advanced Cellular Therapies have warned that the pandemic has led to more blood cancer diagnoses in emergency settings, when the likelihood of survival is worse.

In a report launched today, Scared & Forgotten: An inquiry into the impact of COVID-19 on blood cancer services, compiled by charities Blood Cancer UK and Anthony Nolan,the APPGs highlight NHS data showing that:

  • More blood cancers were diagnosed through emergency presentation at A&E than any other route from May to September 2020 in England.*
  • New blood cancer diagnoses fell by 27% in April and May 2020 compared to the same months in 2019, and as of September 2021 (the latest data available) blood cancer diagnoses remain below the average for 2019.

People with blood cancer diagnosed in A&E are known to have significantly reduced chances of surviving compared to those diagnosed via an outpatient appointment. Only 40% of people with blood cancer live for three years or more if they are diagnosed in emergency settings, compared to 77% of those diagnosed via their GP.

The report is the culmination of an inquiry held by the APPGs into the impact of the Covid-19 pandemic on blood cancer services. Experts who submitted evidence to the inquiry also expressed concern that the large drop in new blood cancer diagnoses at the height of the pandemic, combined with longer NHS waiting times, will lead to more people being diagnosed at advanced stages of disease, when they may have fewer treatment options.

Nigel Griffiths, who had a stem cell transplant nine years ago to treat acute myeloid leukaemia, stressed that the NHS needs funds and resource in order to recover. 

He said: “I went to hospital for my annual check up a while ago and I’m still waiting for my blood test results, I’ve never had to wait this long before. I’ve been told that it’s due to staffing issues - they just don’t have the secretarial staff to type them up.”

Chair of the APPG on Blood Cancer, Henry Smith MP said: “Receiving a blood cancer diagnosis is devastating. No one should have the added distress of receiving this news through an unplanned emergency admission. We must ensure the NHS is equipped with the resources it needs to tackle the long-standing crisis in blood cancer diagnosis which the pandemic has sadly exacerbated.”

Chair of the APPG on Stem Cell Transplantation and Advanced Cellular Therapies, Mark Tami MP added: “We don’t have enough data to show what many in the community strongly suspect - that blood cancer survival will decline for the first time as a consequence of this pandemic. While addressing the backlog must be a priority, there is also a need for more ambitious targets for blood cancer survival over the longer term.”

Building on the evidence and testimony from blood cancer patients, families, and professionals received during the inquiry, the APPGs are recommending:

  • As soon as is feasible, the NHS should evaluate blood cancer outcomes during the pandemic, such as stage of diagnosis and survival compared to before the pandemic, to inform where additional targeted attention is required.
  • Clearer and more ambitious targets for blood cancer survival over the longer term, to ensure that progress is made.
    • This can only be realised with additional resource from the government to meet increased demand, tackle the backlog and ensure equitable access to care.

A full list of recommendations can be found in the report available at https://www.anthonynolan.org/sites/default/files/2022-03/Scared%20and%20Forgotten%20APPG%20report.pdf

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Notes to editor:

  • *This data is from the NHS COVID-19 rapid cancer registration and treatment dataset available at https://www.cancerdata.nhs.uk/covid-19/rcrd. Information on the number of new blood cancer diagnoses in England was taken from the “Demographic factors” tab, selecting “Cancer group: Haematological” and “Demographic level: Route to Diagnosis”.
    • In this dataset “haematological cancers” consists of Hodgkin lymphoma, non-Hodgkin lymphoma, multiple myeloma, lymphoid leukaemia, and myeloid leukaemia.
    • Data for individual blood cancers also shows increases in the percentage of emergency admissions during the first phase of the pandemic (May-Sept 2020) including for blood cancers that historically have relatively lower rates of emergency diagnosis, such as multiple myeloma.
    • For example, 42.2% of new multiple myeloma diagnoses in May 2020 were through emergency admission compared to 26.6% in May 2019, a higher proportion than two-week wait referrals (25.3%) or any other route to diagnosis. Emergency diagnosis continued to be the predominant route to diagnosis for multiple myeloma from May to September 2020.
    • Similarly, 35.1% of Non-Hodgkin lymphoma diagnoses were through emergency admissions in May 2020, compared to 31.3% in May 2019 and a higher proportion than other routes to diagnosis in that month.
  • The report of the APPGs, Scared & Forgotten: An inquiry into the impact of COVID-19 on blood cancer services can be accessed via https://www.anthonynolan.org/sites/default/files/2022-03/Scared%20and%20Forgotten%20APPG%20report.pdf
  • The inquiry received written submissions and heard oral evidence from nearly 70 individuals and organisations, including people living with blood cancer, their carers and families, healthcare professionals, patient organisations and charities.
  • The report is not an official publication of the House of Commons or the House of Lords. It has not been approved by either House or its committees. All-Party Parliamentary Groups are informal groups of Members of both Houses with a common interest in particular issues. The views expressed in this report are those of the group.
  • The report was compiled by Blood Cancer UK and Anthony Nolan who provide the Secretariats to the All-Party Parliamentary Group on Blood Cancer and the All-Party Parliamentary Group on Stem Cell Transplantation and Advanced Cellular Therapies respectively.