I was given a terminal bowel cancer diagnosis and told I had months to live. What I discovered next left me furious with my doctors... and there are countless people in the same situation

Anne Shaw and her husband Louis like to travel. In the past three years, they have treated themselves to a couple of Caribbean cruises, as well as trips to their holiday home in Crete.

But this isn’t an everyday tale of retired folk relaxing into their post-work years because Anne, 69, a former workplace trainer from Leeds, is in a race against time. She was diagnosed with terminal cancer in 2021, when doctors revealed there was nothing they could do to stop the spread of the disease in her bowel.

‘I just felt numb when they told me,’ says Anne. ‘Louis and I looked at each other and could not take it in. Initially, they told me I might have only three months to live, which was terrifying.’

Thankfully, that prognosis has improved with the arrival of immunotherapy drugs, which have kept the cancer in check.

But Anne discovered something almost more troubling than her cancer fate. After breaking the news about her life-changing diagnosis, the consultant at St James’s University Hospital in Leeds revealed that doctors had failed to identify a 5p-sized tumour on one of her ovaries that was clearly visible on scans two years earlier.

This cancer had since spread to her bowel and was now untreatable. Had it been picked up at the time, Anne was told, it would have been treatable with surgery and chemotherapy – likely avoiding the cancer spreading and becoming terminal.

‘We were so angry. More than three years later, Louis and I are still having counselling to help us cope with the impact of it,’ she told Good Health.

It’s a shocking tale but a disturbingly common one, according to a new report by the Parliamentary and Health Service Ombudsman (PHSO), which investigates complaints against the NHS.

The report said repeated failings in the way NHS scans are read were leading to delays in diagnosis and avoidable deaths.

In the past four years, the PHSO has upheld, or partly upheld, 40 complaints against the NHS involving scans not being done or delayed, and failures to follow up on results.

Cases in the report included an 82-year-old grandfather who was diagnosed with aggressive bowel cancer only after his fifth visit to A&E in three months, complaining of severe pain.

It transpired that doctors failed to identify the tumour on multiple scans, which meant by the time it was diagnosed, the cancer had spread and was terminal.

The patient took his own life before treatment could begin, leaving a note to say he could no longer bear the pain.

The Ombudsman Rebecca Hilsenrath said after the report’s findings: ‘It’s vital that action is taken to improve the digital infrastructure of the NHS and make sure people are correctly diagnosed and swiftly treated.

‘NHS leaders need to address this as the important patient safety issue that it is.’

It’s not the first time alarm has been raised over cancers being missed on scans.

In 2022, researchers at the University of Birmingham examined scans of pancreatic cancer patients from two NHS trusts, and concluded that thousands of patients across the country may have died prematurely because of failure to spot the disease.

Almost one in 12 cases they investigated were categorised as PIPC – or post-imaging pancreatic cancer – meaning they were diagnosed late and only as a result of other factors, such as unexplained pain, after their cancers were not spotted on CT and MRI scans.

So why are tumours being missed? NHS England carries out 43.3 million imaging tests every year, for everything from broken bones and pregnancies to heart disease and suspected cancer.

The vast majority are standard X-rays, where radiation is used to create images of bones and tissues inside the body.

The rest are ultrasound tests (soundwaves are fired into the body to produce pictures of internal organs); CT scans (X-rays with computer technology to produce a much more detailed image) and MRI scans, which use strong magnetic fields and radiowaves to peer inside the body.

While X-rays are usually interpreted by technicians called radiographers, the other more complex scans (including breast X-rays called mammograms) that are used to diagnose cancers fall to radiologists. These are trained doctors who would have spent up to seven years specialising in radiology after a traditional five-year medical degree.

Yet even for the most highly skilled clinicians, pinpointing problems can be complex and difficult, says Dr Katharine Halliday, president of the Royal College of Radiologists. ‘The first thing you have to learn is what “normal” is, and that can vary from one person to another,’ she told Good Health.

‘Then you have to be able to recognise things that may look abnormal on an image but are not necessarily sinister.

‘And when it comes to cancer, remember tumours start from just a few cells, so if you’re going to catch it early you’re looking for something really, really small.

‘There’s a lot of interpretation involved – it’s not like radiologists get an image that says red for cancer, green for the all-clear.’

And looking for that detail doesn’t only require expert knowledge, but is also time-consuming.

For example, if a patient undergoes a ‘neck-to-pelvis’ CT scan (commonly offered on the NHS to anyone with a suspected tumour, injury or infection affecting the torso), this can generate hundreds of separate images and ‘each one is looked at in detail’, says Dr Halliday.

And it’s not necessarily sloppy workmanship that is to blame when things are missed, the Royal College of Radiologists claims. For years, it has been warning that its members are unable to cope with their burgeoning workload because there are too few qualified consultant radiologists.

It estimates there is a 30 per cent shortfall in the number needed and that, without urgent action to boost funding and recruitment, this will extend to 40 per cent by 2028. The upshot, it claims, is that the existing workforce is under pressure to process more and more scans and as quickly as possible – making mistakes more likely.

Indeed a 2018 study in the British Journal of Radiology looked at the working patterns of 86 neuroradiologists (who specialise in brain conditions) and found many were routinely working 12-hour days and taking breaks of 15 minutes or less because of their workload.

The researchers warned the situation was potentially dangerous and that patients were being put at risk. More recent data suggests they still are.

NHS figures from November 2024 revealed that, in the first half of last year, it took more than a month for the results of 420,000 scans, including MRIs and CTs, carried out in England to be reported back to the patients.

This is despite the fact that a year earlier, the NHS set a target for all scan results to be fed back to patients in 28 days – in order to ensure treatment begins promptly and patients have a better chance of making a full recovery.

Anne, who had already survived both breast and ovarian cancer, underwent a routine CT scan in 2019 for another health condition, lupus (an autoimmune disease where the body attacks its own tissues and organs).

The scan, it later transpired, had also picked up a 5p-sized tumour on one of her ovaries – but it went unnoticed, largely because it was not a cancer specialist who inspected the image but a medic looking at the effects of lupus.

The following year, in 2020, Anne developed frequent abdominal pains and returned to St James’s Hospital for a check, only to be reassured by a doctor that everything was fine.

Anne adds: ‘I knew I was at risk of getting cancer again and the lupus had all but wiped out my immune system [which meant her body was less able to fight off another tumour]. But when I raised this, the doctor made me feel like I was being silly and worrying over nothing.’

However, the pain worsened and when Anne returned to hospital for further checks in 2021, a CT scan showed extensive tumours on her bowel.

She underwent prompt surgery to remove part of her stomach and bowel and was fitted with a stoma bag.

Although given a bleak prognosis of just three to 12 months when diagnosed, she has since been told she could live another ten years – if she keeps responding well to immunotherapy. Leeds Teaching Hospitals NHS Trust, which operates St James’s, apologised to Anne and paid an undisclosed sum in compensation.

But since her ordeal, Anne has been campaigning for a new rule for two doctors to vet all NHS scans in a bid to stop patients’ lives being shortened by missed or delayed diagnoses – particularly in cases like hers where she had a history of cancer that put her at higher risk.

This already happens with mammograms, whether or not a woman has had breast cancer, as part of the NHS breast cancer screening programme. But there is no requirement elsewhere for X-rays, CT or MRI scans to be routinely inspected by more than one radiologist. ‘Sometimes we do use two people,’ says Dr Halliday, who specialises in paediatric radiology at Queen’s Medical Centre in Nottingham. ‘But if every scan needed to be checked by two specialists, that would slow things down more – and people already wait long enough for results.

‘It would also put doctors under additional pressure.’

One of the pitfalls of patients slipping through the net is that they often undergo more scans to detect what’s behind their symptoms (if their tumour had been spotted first time, they might not have needed these extra scans).

This means being exposed to greater levels of radiation, particularly in the case of X-rays or CT scans. This is important because there have been persistent concerns that, for some people, this in itself increases the risk of cancer. US research published last month in The Lancet Oncology claimed CT scans (which deliver a radiation dose 70 times higher than conventional X-rays) are responsible for up to one in 20 cancers, especially in young children.

Researchers, from the University of California, warned the risk of getting cancer from CT scans was on a par with drinking too much alcohol or gaining excess weight.

However, the US has one of the highest rates of CT scan use in the world – around 250 scans a year per 1,000 people. In the UK it’s fewer than 100 scans per 1,000 people. Dr Halliday says: ‘Whenever we get a request for a CT scan, we always ask whether the benefits outweigh the risks.

‘I work with children and they are more sensitive to the DNA abnormalities that any radiation can cause, so we are especially careful when it comes to scans.’

She says modern CT scanners deliver much lower doses of radiation, although many NHS hospitals do still have older models.

Similarly, other studies have suggested repeated exposure to dental X-rays may increase the risk of thyroid cancer by up to 80 per cent.

But Dr Halliday says: ‘Anyone undergoing two or three dental X-rays in a year, for example, has nothing to worry about – the dose used in these is extremely low.’

However, she cautions against unnecessary use of whole-body CT scans, for which private clinics can charge up to £1,500, to otherwise healthy people who want peace of mind.

‘It’s not just unnecessary exposure to radiation – these scans can throw up all kinds of things that might look abnormal but do no harm, leading to further unnecessary tests.’

Meanwhile, scan-related mistakes are not always about failing to spot something suspicious – sometimes doctors fail to act quickly, with devastating consequences.

In November 2023, 70-year-old Jim Johnson, from Gateshead, died from a lung tumour that had spread to his spine.

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The cancer had shown up on a chest X-ray a year earlier (in April 2022), when he was admitted to hospital after a fall at home.

A radiographer had identified the suspicious shadow on the scan and recommended that Jim be referred to a chest specialist as soon as possible. But the recommendation went unnoticed.

Just over a year later, Jim was admitted to hospital with severe breathing difficulties. Checks showed the lung cancer had spread to his spine and at that point was untreatable. Jim died six months later.

His wife, Eva, 71, said: ‘We thought we’d have many more years together – we were married for 50 years – and it’s difficult not to think we’ve been robbed of those years.’

A Patient Safety Incident Case Review by Gateshead Health NHS Foundation Trust found there was a ‘lack of ownership’ for the test results of patients who transferred from the emergency department to speciality care areas.

Jim’s X-ray was missed, it found, because, as he moved through the system, staff simply failed to study his file properly.

Anne, meanwhile, is understandably angry about what happened to her. ‘Yes, I got a payout, but nothing can compensate for the damage that’s been done,’ she says.

Human error is one of the biggest risk factors in the correct interpretation of X-rays and scans.

So could artificial intelligence do a better job? The technology works by using algorithms that ‘learn’ to identify patterns within the images that signify a problem.

The most recent advances are:

SKIN CANCER: AI that can spot deadly melanoma skin cancer in its earliest stages was last week given the go-ahead for use on the NHS. Staff use a smartphone with a high-tech magnifying lens installed to take an image of the suspicious mole, which is then analysed by the software, called DERM. Tests suggest it is so accurate at picking out early malignant melanomas that it could dramatically cut the number of urgent referrals to dermatologists for lesions that turn out to be benign.

FRACTURED BONES: Earlier this year, NICE announced the rollout of four AI programs to help doctors catch hard-to-spot fractures – studies suggest AI increases the accuracy of fracture detection by about 15 per cent. More than £1 million a year is currently spent on compensation for patients whose fractures were missed, often in A&E.

BREAST CANCER: Doctors in Grampian, north-east Scotland, have been testing an AI tool called Mia to see if it can pick up breast tumours on 10,000 mammograms. They found it not only picked up every cancer case that medics did, but also spotted another 11 cases that they had missed.

PROSTATE CANCER: A Dutch study in Lancet Oncology in 2024 found AI trained to detect prostate cancer on CT scans did a better job than doctors – spotting that some tumours were at a more advanced stage than the medics had said.

BRAIN TUMOURS: Scientists at the National Cancer Institute in the US have developed an AI system, DEPLOY, which makes it easier to find brain tumours and identify their genetic profile with 95 per cent accuracy, it reported last year. This could speed up decisions on what drugs should be used to treat the tumour – potentially improving recovery.