Third of Scots cancer cases only detected after emergency hospital admissions

Nearly one in three cases were only identified after patients ended up in emergency departments.

Jo Nove, acting chief executive for Myeloma UK, said: “You would be amazed by the number of people who only have their myeloma diagnosed when they present at A&E with an unexpected severe break - they’ve jolted a table and their hip’s broken, for example.

“We had one patient who was only diagnosed because his arm got caught in a closing Tube door and it snapped his arm.”

Jo Nove

The report comes as a study revealed that 38.5 per cent of cancers in Scotland - including 59% of pancreatic cancer cases - were picked up between between 2012 and 2017 following emergency hospital admissions, compared to 37% in England and 37.4% in Wales.

The UK as a whole lagged behind Canada and Australia, where it was as low as 24%, but appeared to be performing better than New Zealand where 42.5% of cancers were detected as a result of emergency presentations.

The findings by researchers at University College London are the result of the first study of its kind comparing cancer diagnoses in six countries, also including Denmark and Norway.

CASE STUDY: Young mother's excruciating blood cancer symptoms missed in pregnancy

The study, published in the journal Lancet Oncology, also comes amid concerns that the pandemic has resulted in more cancers being missed - with nearly 800 fewer breast cancer diagnoses in Scotland in 2020.

Andy Glyde, Cancer Research UK’s senior external affairs manager in Scotland, said: “This study is truly worrying.

“It confirms that too many people in Scotland are only being diagnosed with cancer once their health has deteriorated to a point when they might need to be rushed into hospital.

“We can also see that Scotland is performing poorly compared to some other countries. This is concerning because countries that have higher levels of emergency presentations have lower cancer survival.”

Older patients and those with advanced cancer were most likely to be diagnosed through an emergency route – as were cancers with often non-specific, vague symptoms, such as pancreatic, liver, lung, and ovarian.

This is also a problem for myeloma, which is characterised by pain, easily broken bones, fatigue and recurring infection.

It is caused when abnormal cells begin spreading in the bone marrow, damaging the immune system and weakening bones.

Although incurable, patients clinical outcomes and quality of life can be substantially improved if the disease is detected early.

READ MORE: Warning A&E facing 'biggest patient safety crisis in a generation' as 12-hour waits spiral

However, data shows that diagnoses fell by 13% in England after the pandemic - a situation Myeloma UK expects to be mirrored in Scotland - and while there are currently 2,000 people in Scotland living with myeloma, doctors tend to encounter the condition only rarely.

By the time it is detected, the majority of patients have suffered irreversible damage.

Myeloma UK’s report - which is the first to investigate the hidden impact of delayed diagnosis for patients across the UK - found that 34% had suffered spinal fractures, and 60% had reduced mobility.

“Often GPs would be lucky to see two cases of myeloma in their career,” said Ms Nove.

“But the earlier we catch it, the less damage has been done - less bone damage, less chronic pain, less kidney damage, fewer recurring infections - we can keep your quality of life better for as long as possible.”

The charity is funding research into precursor conditions which can be a signal of myeloma, with a view to developing cost-effective screening tools for the condition.

It is also calling on the Scottish Government to “put the day-to-day lives of people with myeloma front and centre across research, policy development, commissioning, and clinical practice” as part of its forthcoming cancer strategy.