Cancer Referral Targets

Lord Allan of Hallam Excerpts

Monday 5th June 2023 Lords Chamber

[Lord Markham (Con)]

I am not exactly familiar with the test that my noble friend might have taken but many of us will have heard about the early promise shown by the GRAIL programme. It is a simple blood test and, right now, has a two-thirds success rate for early detection. Those are early indicators, but early diagnosis and innovative approaches such as the GRAIL blood test are important.

[Lord Allan of Hallam (LD)]

My Lords—

[Lord Patel (CB)]

My Lords, I interrupt to say that, while the new test shows promise, it is nowhere near perfection. The sensitivity of the test is extremely low and false positive rates are high. This is cell-free DNA testing, including machine learning. It may be the promise of five years to come that we detect cancers at an early stage, which would be the holy grail, but we must not hype the test at this point and raise false hope.

--- Later in debate ---

[Lord Markham (Con)]

The noble Lord is absolutely correct that we always need to keep these things in balance. What I was trying to express was that we have an opportunity to innovate in this space. We have another innovation in our targeted lung cancer programme, which has now been rolled out to 43 sites. In 2019, 50% of such cancers were not detected until stage 4. Now, through mobile delivery of services to these sites, we are detecting 60% of such cancers at stage 1. Those are the sort of innovations for which we have very solid data, and they do show promise for the future.

[Lord Allan of Hallam (LD)]

My Lords, national waiting times for cancer treatment have fallen way off target, as the noble Baroness, Lady Merron, set out in her Question, but these national numbers mask significant regional variations. In March, they ranged from 45% of referrals within the target time in Birmingham and Solihull to 80% within target in Kent and Medway. How does the Minister account for such significant variations and what are the Government doing to level up those integrated care board areas that are falling furthest below the targets?

[Lord Markham (Con)]

That is exactly the example I was giving when I mentioned lung cancer targets, where mobile devices are being used. Interestingly, the most deprived areas have been targeted because they are often areas of high smoking, and these are the areas where they have managed to get screening times down the most. We have the opportunity to put CDCs in the areas of most need. We all agree that there is unprecedented demand and that we have to expand supply; there is no other way to meet that demand but to expand supply.