‘Cancer report provides information but zero accountability’

The recently-published Channel Islands Cancer Report provides a valuable overview of cancer in Guernsey. Yet it also highlights a critical gap that prevents us, as a community, from understanding whether cancer care on the island is improving, holding steady or falling behind.

The report provides information but zero accountability.

The report confirms that overall cancer rates in Guernsey are broadly in line with other developed populations.

Cancer is ranked in four stages and it’s clearly critically important that the stage all cancers are first diagnosed at are recorded. Whether that is early at stage 1 or only once it has spread elsewhere from its original source to be ranked as stage 4.

The report shows that melanoma is being caught early in many cases, and that the reporting of lung cancer stages is close to what we should expect. In these particular areas it is reassuring and important to build on this system in other areas of cancer.

The latest cancer report raises this as a major concern which can no longer be ignored. We know how many people in Guernsey are diagnosed with cancer, what types of cancer, we know how many die and we know how this compares with others, locally and if we want to look nationally but that’s all it tells us. What these figures don’t show is what happens in between, because stage data is missing for too many patients.

This means we cannot tell whether cancers are being caught early enough – we cannot tell whether treatment is working well enough – and we cannot tell whether outcomes are improving or getting worse. A modern cancer system cannot function without this information.

Other countries publish annual and five-yearly survival and early-diagnosis results because they understand a simple truth: transparency saves lives. Guernsey does not yet appear to recognise this and in this respect the report provides zero accountability.

The report is also already, clearly, out of date. It stops at 2022. Across the world, since 2020, more cancers are being diagnosed at later stages and international trends show an increase among younger people. If that is happening here, we have no way of knowing until the consequences show up in preventable deaths.

This is not a data problem. It is a decision problem.

Guernsey deserves better than this.

We are not talking vast numbers but around 700 entries a year in total. 15 a week. It is therefore now essential that we:

• Record the stage of cancer at diagnosis for every case or record why it is not possible.

• Report one-year and five-year cancer survival rates every year.

• Treat transparency as a public health necessity, not a bureaucratic option.

These steps are standard worldwide, they are not costly but simply essential.

If we want to be confident in our cancer care, we must be confident in our cancer data.

We cannot improve what we do not measure. And right now, we are not measuring or reporting what matters most.

Bruce Cova MBE