A dramatic rise in bowel cancer cases is set to sweep Northern Ireland in the wake of the Covid-19 outbreak, it has been warned.
It has emerged that at least 30 people may be facing life-changing surgery or even death as a result of the suspension of bowel cancer screening here.
Officials estimate 25 to 30 patients are diagnosed with bowel cancer every three months through the life-saving screening programme, which was suspended in the middle of March as the health service prepared for an influx of critically ill Covid-19 patients.
However, even more patients find out they have bowel cancer as a result of colonoscopies, which have been massively scaled back in recent months.
And concerns are rising about the number of people who will receive delayed diagnoses as a result, as health bosses have said they are unable to give a date for the resumption of bowel cancer screening in Northern Ireland.
Bowel cancer screening and diagnostic tests can pick up patients who are not yet displaying symptoms, which significantly increases a person's chance of survival. The screening programme also identifies people who are at risk of developing bowel cancer so they can be closely monitored, which in turn drastically improves survival rates.
Genevieve Edwards, chief executive of Bowel Cancer UK, said: "We are going to see people turning up in A&E and they are going to be very poorly and it's going to be pretty grim for them."
Professor Mark Lawler, Associate Pro-Vice-Chancellor and Professor of Digital Health at Queen's University, said: "I think it's very worrying, particularly as bowel cancer is much easier to treat the earlier it is detected.
"The screening programme helps us pick people up earlier and if you are moving from a stage one to a stage two or even three cancer, that is much more difficult to treat.
"The biggest challenge now is getting the service back up and running and also reassuring patients that it is safe to go into hospital for a colonoscopy.
"Covid-19 is important, but cancer needs to be back on the agenda as it kills more people than Covid-19."
However, Ms Edwards also warned the health service will struggle to deal with the backlog of patients who have missed screening tests and diagnostic procedures during the pandemic.
While the screening programme identifies people who may have bowel cancer, further tests are required for a definitive diagnosis.
The number of colonoscopies being carried out in Northern Ireland has been vastly reduced as it is an aerosol generating procedure, which is a procedure that increases the risk of staff catching Covid-19 if the patient has the virus.
At the same time, special precautions must be taken between each aerosol generating procedure to reduce the risk to anyone in the environment afterwards. This has resulted in a reduction in surgical capacity.
Ms Edwards added: "It's so difficult because we know that if diagnosed early, bowel cancer is curable. Screening works as it can prevent cancer from developing in the first place yet we're going to see people diagnosed at a later stage as a result of this.
"For some of those people, it will mean years of life lost and a reduced quality of life, it's a heart-breaking position to be in."
A Department of Health spokeswoman said planning is under way for the phased restoration of all population screening programmes but this is complex and needs to take into account a wide range of variables, including PPE and social distancing.