Acting on misinformation to prevent patient harm.

A group of government ministers are in discussions to call for an expansion of the remit of the UK's Cancer Act, according to a recent report. The aim is to broaden the scope of the Act to include the regulation of clinically unproven diagnostic procedures, to prohibit dangerous treatments, and to introduce stricter controls of social media posts about purported cancer cures. The talks between UK members of parliament from across the political spectrum are a remarkable show of solidarity. Following an unprecedented national lockdown introduced across the UK in March, 2020, as a result of the initial COVID-19 outbreak, cancer screening services were suspended, routine diagnostic work was postponed, and urgent referrals for suspected cancer declined dramatically. The absence of National Health Service (NHS)-based cancer diagnosis and treatment, and fears about a huge backlog of patients with cancer in the UK, have left a vacuum that those peddling unproven and unapproved tests and interventions have tried to fill. Thus, review and revision of the Cancer Act to address this emerging threat to patient safety is welcome.

Enacted by the UK Houses of Parliament in 1939, the Cancer Act was introduced with the aim to “make further provision for the treatment of cancer, to authorise the Minister of Health to lend money to the National Radium Trust, to prohibit particular advertisements relating to cancer, and for purposes connected with the matters aforesaid”. Although the Act has since been revised, the remaining provision prohibiting any advertisements that offer to treat or cure cancer remains in effect to this day, and has led to the prosecution of many individuals guilty of advertising unproven cures for cancer, including in the past decade. However, the Act was first drafted before the age of the internet and social media and predates the NHS. Therefore, despite original intentions to ban adverts for fake cancer cures from any source, the content does not reflect modern times. Crucially, the Act does not cover advertising of purported cancer diagnostic tests (eg, thermography) or the undertaking of such tests that, although unapproved and often debunked, have been shown to lead to false hope for those with cancer and even the tragic deaths of some patients. Tighter regulation is, therefore, needed to prevent the dissemination of misleading claims used to market health products or tests, especially online.

Online advertisements, and particularly social media, are largely responsible for the the widespread visibility of unapproved cancer diagnostic tests and false cancer cures. Individuals preying on the vulnerability of patients to sell fake medical products is an age-old problem, but the advent of social media has led to an exponential proliferation of advertising of such products online. With the added challenge of COVID-19 lockdowns in various countries affecting cancer care, patients with cancer and their families might be even more susceptible to advertisements that offer hope for their illness. In some countries, such as the USA, advertisement of genuine and clinically proven cancer treatments are permitted, which can make the regulation of unproven so-called miracle cures for cancer particularly difficult in the absence of relevant regulations.

Fortunately, steps are being taken to combat this rise in misinformation. Public advocacy groups and patients themselves are actively working to encourage the public to report any potential scams or misleading health information. Social media companies have also implemented measures to crack down on accounts that spread scientifically unsound and potentially harmful information about sham cancer treatments. But the rise in misleading information in relation to the COVID-19 pandemic suggests that existing measures are not sufficient and further efforts are needed to halt this trend.

To reduce, if not eliminate, the promotion of fake cancer cures, a multifaceted approach is needed. Public awareness of false claims and ongoing campaigns to increase vigilance are, of course, invaluable. The responsibility of media outlets involved in the dissemination of questionable information in curbing such activities is clear. But perhaps the biggest impact will come from having concrete legislation. Discussions among government ministers in the UK in this regard are promising, but must result in rational amendments in the Cancer Act legislation that hold perpetrators to account. Ministers must capitalise on this opportunity to draft strong, clear, and enforceable laws. These actions are a crucial step in preventing harm to patients with cancer.