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After many years of increases, the latest figures on new cancer diagnoses in Scotland highlight unusual decreases in numbers in 2020. The report finds that nearly 2,800 fewer cancer diagnoses were made in 2020 compared to the previous year – a fall of 8%. Even larger decreases have been recorded for specific cancers – diagnoses for bowel and cervical cancer fell by a fifth and a quarter, respectively.

The decreases are most likely due to under-diagnosis of cancer because of the disruptions of COVID-19. The pandemic had a huge impact on all aspects of cancer control in Scotland – screening programmes were paused, and patients were less likely to seek help during lockdown periods.

Decreases in cancer diagnoses were seen to a greater extent in more socio-economically deprived areas. Rather than this meaning fewer people had cancer, it is likely that people from deprived areas were not getting their cancers diagnosed.

Outcomes from cancer are better when diagnosed at the earliest stage. However, it appears that the pandemic had a greater effect on these more treatable cancers. Diagnoses of early-stage cancer decreased more than for late stage disease. Early-stage breast, bowel and cervical cancer diagnoses probably fell most because of pauses in cancer screening programmes.

Prof David Morrison, Director of the Scottish Cancer Registry, said,

“Usually, a fall in new cancer diagnoses suggests that we are getting better at preventing it. But in 2020, the drop in expected cases suggests that people still had cancer but were not being diagnosed.

“The pandemic has affected cancer care in many ways. Public Health Scotland is working with a range of clinical, management and policy colleagues to inform the recovery of cancer and screening services, and to diagnose cancer in Scotland at the earliest stage.

“I would encourage anyone who gets an invitation for cancer screening to take it. If you are worried about an unusual symptom, don’t put it off - get in touch with your GP.

“It is worth remembering that about 4 in 10 cancers could be prevented through changes in our behaviour. It is never too late to benefit from stopping smoking, losing weight if you are very overweight, drinking sensibly, and protecting yourself from sunburn.”

Read the full PHS report Cancer Incidence in Scotland to December 2020