Cancer screening and better clinical diagnosis should not be in competition

Cox at al.1 point to limitations in colposcopy services for cervical cancer and treatment services for breast cancer, and state that the limitations of clinical services-particularly for colonoscopy- necessitated a reduction in test sensitivity and a narrower age range for the bowel cancer screening programme when first introduced. If the extra work is not adequately resourced, diagnostic and treatment services for other patients will be disadvantaged. [...]the time from diagnosis to surgery in breast cancer for all patients has been increasing, with the proportion having surgery within 31 days dropping from 56% to 37% between 2004 and 2019, even before COVID-19.8 The clinical diagnosis route in New Zealand is far from satisfactory. Risk factors and prognostic implications of diagnosis of cancer within 30 days after an emergency hospital admission (emergency presentation): an International Cancer Benchmarking Partnership (ICBP) population-based study.