In this blog look at new data published by the Welsh government which shows how COVID-19 disrupted breast cancer detection and how this could affect people affected by breast cancer in Wales.
We look at new data published by the Welsh government which shows how COVID disrupted breast cancer detection and how this could impact people affected by breast cancer in Wales.
Earlier this year, our blog set out the shortfall in breast cancer diagnoses seen during COVID in England, Scotland and Northern Ireland.
We now have data showing how Wales was impacted, which could help us understand the long-term impact of pandemic disruption and inform how breast services recover.
The fall in diagnoses
In 2020, 2,312 women were diagnosed with breast cancer in Wales. This was a 17.2% decrease in diagnosis compared with the year before, with 481 fewer women diagnosed. The decline in breast cancer diagnoses in Wales was the largest seen across the UK nations, and was bigger than the dip seen in other common cancers in Wales, including bowel, ovarian and lung. The number of male breast cancers diagnosed also fell from 19 in 2018, to 15 in 2020.
Decline in early diagnosis
As well as fewer breast cancers being diagnosed, the number being detected early, at stage 1 and 2, fell even further. The number of breast cancer cases diagnosed at stage 1 in women in 2020 fell by 30.6%, and the number diagnosed at stage 2 also dropped by 10%.
Timeline of diagnoses
Unsurprisingly, the fall in breast cancer diagnosis in Wales was greatest at the outset of COVID, with the number of female breast cancer diagnoses falling by 40.6% in April 2020 compared to the pre-pandemic average. Thankfully, breast cancer diagnosis rates recovered to the pre-pandemic average in September 2020.
Impact of screening disruption
The data also makes clear that the pause in screening resulted in fewer diagnoses being made. Due to the impact of screening services being paused in March, the number of breast cancer cases diagnosed at stage 1 between April and December 2020 fell by almost 40% compared to the pre-pandemic average.
Previously published data showed that even once screening was restarted in Wales, the proportion of women taking up their routine screening invite was only 67.1% between April 2020 – March 2021, and there was a 18.9% gap in breast screening uptake, between the least and most deprived areas of Wales.
Despite the tireless work of NHS staff, the programme isn’t projected to fully recover, so that all women are invited to screening on time, until April 2025.
What’s next?
At the beginning of the year, the Wales Cancer Network published its Cancer Improvement Plan. Within the plan, Public Health Wales does commit to work with partners, including charities, to improve uptake and reduce inequalities in screening, but we were disappointed to see the lack of concrete initiatives or targets attached to this ambition.
We want Breast Test Wales, Public Health Wales, and the Wales Cancer Network to work with us to identify how we can reverse the long-term decline in breast screening uptake, shrink inequalities and maximise the positive impact screening can have on women’s lives.
We’ll also be looking to influencing the implementation of the National Workforce Implementation Plan, along with the delivery of other commitments within the Cancer Improvement Plan, to ensure the delivery of a breast cancer pathway which meets the needs of patients across Wales.
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