SURVIVAL rates for patients diagnosed with cancer during 2020 were lower compared to those diagnosed before the pandemic. 

Statistics from Public Health Scotland (PHS) show that for all cancers combined, one-year survival rates were 67.5 per cent in 2020 compared to 71.1% for patients diagnosed in 2018 and 2019.

There was a significant difference in survival for colorectal and prostate cancers in particular - down 6% and 1.8% respectively - although women with breast cancer did not appear to experience any fall in survival rates. 

PHS said the lower survival estimates for patients diagnosed in 2020 "likely reflect both under-diagnosis of early-stage cancers and delayed diagnosis/treatment".

READ MORE: Deaths in Scotland are on the rise - so what's the cause? 

Patients diagnosed at the height of the pandemic - between April and the end of June 2020, when services were most disrupted - appeared to have the worst outcomes. 

PHS said the one-year survival estimate for patients diagnosed with any form of cancer in the second quarter (Q2) of 2020 was 9% lower compared to those diagnosed between January and March (Q1) 2020. 

For colorectal cancer the difference was 13%. 

The report adds that for the cohorts diagnosed in Q3 and Q4 of 2020 "one-year overall survival estimates appeared generally higher than in the Q2 2020 cohort, perhaps suggesting the start of a gradual return to pre-pandemic trends". 

The Herald:

The early stage of the coronavirus pandemic was associated with an 8% reduction in cancer diagnoses.

The PHS report said: "As a consequence of the first lockdown in 2020, referrals resulting in a cancer diagnosis fell substantially, with patients not being screened, patients being less likely to seek help or more likely to experience delays in investigations.

"Previous PHS reports have shown that the pandemic led to substantial under-diagnosis of cancers in 2020, with an 8% reduction in diagnoses for all cancers, and larger falls for early stage diagnoses in some cancer types."

READ MORE: Cancer in Scotland - waiting times, incidence, and mortality

It added that while it is "reassuring that survival estimates for quarterly cohorts began to return to pre-pandemic trend in late 2020", there "may still be 'missing' patients who will be diagnosed later than they would have been had the pandemic not occurred, perhaps with more progressed cancer and poorer outcomes".

PHS stresses that it is "unclear whether patients diagnosed in 2020 had poorer survival than they would have done had the pandemic not occurred", but said that the statistics "underscore the substantial impact of the pandemic on cancer services in Scotland". 

However, recent figures indicate that excess deaths from cancer in Scotland have not increased despite the impact from the pandemic. 

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According to data from the National Records of Scotland, the age-standardised mortality rate from cancer in March was 1.7% lower than the five-year average.

This compares trends in 2023 against 2017, 2018, 2019, 2021 and 2022 combined, after adjusting for changes in the age and size of the population. NRS excludes 2020 as an outlier, due to the pandemic. 

READ MORE: Why are cancer deaths in Scotland lower in 2022 than before the pandemic? 

It comes as a separate report published by PHS shows that the number of eligible women screened for cervical cancer has fallen.

In Scotland, women aged between 25 and 49 years old are invited for a smear test every three years, while women aged between 50 and 64 are invited every five years.

According to PHS, just 68.7% of women were up to date on their screening in the year up to March 2022 - down 0.7% year-on-year.

Only 65.7% of women in the 25 to 49 age group were up to date with screening compared to 73.7% of the older age group.

Overall, uptake ranged from 62.4% for women living in the most deprived areas of Scotland to 73.1% in the least deprived.

The Herald:

Samantha Dixon, the chief executive of charity Jo's Cervical Cancer Trust, said: "To see falling cervical screening coverage in almost every age group, and almost all health boards is alarming.

"We have a test that can stop cervical cancer yet over one in three are not taking up their invitation.

"The latest statistics clearly show that those living in the most deprived areas are far less likely to go for cervical screening.

"This inequality should not exist and must be a focus for initiatives to increase awareness and reduce barriers to attendance."

READ MORE: Glasgow mother faces 49 week wait for cervical cancer check

A spokesman for the Scottish Government said it was "disappointing" that uptake had fallen and remains below the national target of 80%.

He added: "We recognise that the reasons for this are complex, and that the impacts of Covid-19 may still be playing a part.

"We are working closely with partners to understand if there are any other contributory factors, and to increase uptake once again.

"We committed £2 million over 2021/22 and 2022/23 to tackle inequalities in the cancer screening programmes."