Steep rise in hospital admissions for mouth cancer across Yorkshire amid dentistry cuts, data reveals

Health chiefs must urgently overhaul NHS dentistry to combat rocketing rates of mouth cancer in the UK, including ‘significant’ rises across trusts in Yorkshire, campaigners have warned.

With the number of cases growing by 58 per cent in the last decade, early diagnosis at check-ups is seen as the key to life-saving treatment.

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However, critics say many people were struggling to access NHS dentistry even before the coronavirus crisis forced surgeries to close and then reopen with severely reduced capacity, meaning too often the cancer is often being discovered at a late stage.

NHS Digital figures show hospital admissions for oral cancer increased by 30 per cent in England between 2010/11 and 2019/20, to 26,773. Patients will be captured more than once if they have to be admitted for treatment multiple times.NHS Digital figures show hospital admissions for oral cancer increased by 30 per cent in England between 2010/11 and 2019/20, to 26,773. Patients will be captured more than once if they have to be admitted for treatment multiple times.
NHS Digital figures show hospital admissions for oral cancer increased by 30 per cent in England between 2010/11 and 2019/20, to 26,773. Patients will be captured more than once if they have to be admitted for treatment multiple times.
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As part of figures obtained by JPIMedia Investigations, NHS Digital figures show hospital admissions for oral cancer increased by 30 per cent in England between 2010/11 and 2019/20, to 26,773. Patients will be captured more than once if they have to be admitted for treatment multiple times.

Figures from the Oral Health Foundation meanwhile show there were 8,722 diagnoses of mouth cancer in the UK in 2019 – an increase of 58 per cent compared to 10 years ago and up 97 per cent over the last 20 years.

Across Yorkshire and the Humber, there were more than 1,800 hospital admissions for mouth cancer (including NHS-commissioned care at private hospitals) in 2018/19. The highest increase was recorded at the Barnsley Hospital NHS Foundation Trust with a rise of 133 per cent, with 35 people admitted compared with 15 in 2014/15.

A spokeswoman from Barnsley Hospital, said there are many different variables as to reasons for the rise in hospital admissions for mouth cancer.

Figures from the Oral Health Foundation meanwhile show there were 8,722 diagnoses of mouth cancer in the UK in 2019 – an increase of 58 per cent compared to 10 years ago.Figures from the Oral Health Foundation meanwhile show there were 8,722 diagnoses of mouth cancer in the UK in 2019 – an increase of 58 per cent compared to 10 years ago.
Figures from the Oral Health Foundation meanwhile show there were 8,722 diagnoses of mouth cancer in the UK in 2019 – an increase of 58 per cent compared to 10 years ago.
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She said this includes increased general awareness of head and neck cancer and cancer symptoms – highlighted by campaigns such as the ‘Cancer Wants Your Face’ campaign in 2014.

She said: "Dentists and GPs are referring and people who have been made more aware of the symptoms have been visiting their GP.

“Anyone concerned about their symptoms should visit their GP as soon as possible."

Mid Yorkshire Hospital NHS Trust followed with an increase of 50 per cent - treating 90 patients in 2018/19 up from 60 patients.

Dr Phillip Lewis, from the Mouth Cancer Foundation.Dr Phillip Lewis, from the Mouth Cancer Foundation.
Dr Phillip Lewis, from the Mouth Cancer Foundation.
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Trudie Davies, Chief Operating Officer at The Mid Yorkshire Hospitals NHS Trust, said there are several contributing factors that would lead to the increasing number of oral cancers.

She said: "We would encourage all dentists and GPs to refer people as early as possible.

“Ease of access to primary care is essential in the strategy to improve detection rates of early oral cancer.”

Ms Davies added over the last few years The Mid Yorkshire Hospitals NHS Trust has organised regular Mouth Cancer Awareness Week events and has taken part in the West Yorkshire Head and Neck Cancer Awareness Campaign.

Professor Zoe Marshman, honorary consultant of dental public health at Sheffield Teaching Hospitals.Professor Zoe Marshman, honorary consultant of dental public health at Sheffield Teaching Hospitals.
Professor Zoe Marshman, honorary consultant of dental public health at Sheffield Teaching Hospitals.
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And consultants have supported GP and dentist education programmes in the early detection of oral cancer by supporting events such as 'Target Cancer'.

Hull and East Yorkshire Hospitals NHS Trust received the most number of admissions with 785 in 2018/19 - an increase of 15 per cent over four years. While in South Yorkshire Sheffield Teaching hospitals NHS Foundation Trust followed with 615 - a decrease of 21 per cent, compared with 780 admissions in 2014/15.

NHS North Lincolnshire Clinical Commissioning Group saw an increase of 65 per cent, with 140 admissions up from 85.

Some 2,701 people died from the illness in 2018. The British Dental Association (BDA) warns many people may now be “walking around with oral cancer that hasn’t been picked up” thanks to the pandemic.

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Dr Phillip Lewis, of the Mouth Cancer Foundation, said patients should see a dentist at least once a year, but in practice millions of people do not meet even this most basic recommendation.

The number of missed NHS dental appointments had reached 15 million in the year to the end of August when compared to the same period in 2019, according to the organisation.

Chairman of the BDA, Eddie Crouch, said: "Dentists are on the frontline for picking up on the telltale signs of oral cancer. The condition claims more lives each year than car accidents, and early detection really is key.”

But he said that “millions of patients are now struggling to get an appointment”, adding: “For years check-ups have been effectively rationed which made the early detection of these life changing cancers an unacceptable lottery.”

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Even before the pandemic, an estimated 4m people in England were not accessing NHS dentistry because they could not find a practice, could not afford the charges, were on a waiting list or had not even tried to find a dentist because they assumed they would fail, the BDA said.

Now with practices operating at a fraction of their former capacity, numbers have surged.

Dr Phillip Lewis, of the Mouth Cancer Foundation, said patients should see a dentist at least once a year, but in practice millions of people do not meet even this most basic recommendation.

He said: “The chances of treating mouth cancer are the greatest when it is found early - but it is often discovered late because patients have not been coming in for regular examinations.

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“When mouth cancer is discovered in its earliest stages the chances of complete cure over five years are really good - about 95 per cent.

“But as soon as there is a time delay and the cancer spreads, the survival rates absolutely plummet and the treatments are really unpleasant.”

Dr Lewis said an “underfunded” system, an inadequate target-driven contract and problems with recruitment were all factors in limiting access to NHS dentistry.

A spokesperson for the Department of Health and Social Care, which is responsible for dentistry in England, said: “Every cancer patient deserves the best possible care and we are committed to detecting more cancers at an earlier stage to save an estimated 55,000 lives a year by 2028.

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“As part of this, every dentist is expected to fully assess their patient’s oral health to look for the signs of cancer.”

Early detection is key

- Early detection is key to life-saving mouth cancer treatment, according to a dental expert.

Professor Zoe Marshman, honorary consultant of dental public health at Sheffield Teaching Hospitals, said the disease was on the rise for a number of reasons, including the use of tobacco and alcohol, an ageing population and the human papillomavirus, a sexually transmitted infection linked to mouth cancer.

However, she said that opportunities to detect and treat oral cancers quickly and effectively were being missed because so many people were missing out on regular checkups.

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She said: “It is recommended that adults should go to the dentist at least every two years but there are a lot of reasons why people don’t do that.

“It might be because they don’t think there are any dentists available or it might be or they might be scared after spotting something.

“But if they have oral cancer the best thing for them to do is get to the dentist and get it picked up as quickly as possible.

“If you leave it and you don’t go they get bigger and people end up having to have major surgery.”

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