The UK can expect a “tsunami of missed cancers”, leading experts have said, after an international study found that diagnoses fell sharply during the pandemic. Preliminary figures from the International Cancer Benchmarking Partnership, presented to delegates at the World Cancer Congress in Geneva, compared data on the instance and stage of cancer diagnosis in Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK, before and during the pandemic. The results showed that UK nations had the biggest and most sustained falls in the diagnosis of lung, breast, colorectal and skin cancers during 2020. Particular data for Northern Ireland and Wales showed how badly they did compared with other countries studied. (Data for England and Scotland was still being collated but was expected to be as bad as the other UK nations.) While all countries reported a drop in cases diagnosed at the peak of the pandemic, most had caught up again within the year. In contrast, Wales and Northern Ireland still had not recovered their diagnosis rates by the end of 2020. The study calculated that between April and July 2020, breast diagnoses dropped by 35% in Northern Ireland and Wales, compared with 24% in Norway and 14% in Denmark. For lung cancer, over the same time period the decline was 16% in Northern Ireland and Wales, compared with 10% in Norway or 1% in New Zealand. For the most affected month, 44% of breast cancer cases and 30% of lung cancer cases were missed in Northern Ireland and Wales. There were also sharp declines in colorectal cancer diagnoses. The decline in cases diagnosed was largest for early stage cancers, partly due to the suspension of screening programmes. In Northern Ireland and Wales, stage 1 breast cancer diagnoses declined by 44% and 51%, respectively. Cancer experts said that as a result of such large drops in diagnoses, they are expecting to see many more patients presenting with more advanced, late stage cancers. “These data are a shocking wake-up call, providing the key evidence that the UK can expect a tsunami of missed cancers and a potential shift in stage that may lead to more aggressive cancers that are more difficult to treat,” said Mark Lawler, professor of digital health at Queen’s University Belfast and chair of the International Cancer Benchmarking Partnership. “And the fact we are still way off meeting the 62-day target to treat cancer can only compound the issue.” A leading oncologist and co-founder of the Catch up with Cancer campaign, Prof Pat Price, said: “These figures are a timely and devastating confirmation of the colossal cancer crisis. Without urgent action, we will see more patients diagnosed at a later stage and more patients facing delays to treatment. “We were at the bottom of the cancer league tables before the pandemic, and as this study shows, we’ve simply not recovered from the backlog in diagnosis. However, it does not have to be this way, as Lord Darzi’s new NHS report highlights. If ever there was a time to deliver and implement a dedicated cancer recovery plan it is now.” Naser Turabi, director of evidence and implementation at Cancer Research UK, said: “These findings suggest the UK health system lacks resilience in comparison with countries such as New Zealand, leaving it more vulnerable to the impact of Covid. This could have serious consequences for cancer patients who faced delays to diagnosis as a result of over-stretched services.” A Department of Health and Social Care spokesperson said: “While we recognise the additional pressures placed on the NHS during the pandemic, it is unacceptable that so many people had to wait too long for a cancer diagnosis and treatment. “Lord Darzi’s report laid out how severe the delays for patients waiting for a cancer diagnosis continue to be. This government is determined to change that as we create the 10-year plan to reform the NHS and make it fit for the future. “We will get the NHS catching cancer on time, diagnosing it earlier and treating it faster so more patients survive this horrible set of diseases, and we will improve patients’ experience across the system.”