Welcome to the Cancer Services online newsfeed. Here you’ll find all the latest research, news stories, policy updates and guidelines. View our other newsfeeds for more subject-specific news.
Five steps to getting cancer diagnostics back on track
This report published by Cancer Research UK outlines the current state of play on diagnostics in England and how we can address issues to deliver a world-class cancer service.
A new report highlights five things a post-election UK Government could do to get cancer diagnostics back on track:
- Reform of the UK Government’s approach to investment in health
- Improve workforce planning for diagnostic services
- Setting up screening programmes for success
- Prepare the health system for the adoption of innovation
- Take a strategic approach to diagnostics
Further detail: Five steps to getting cancer diagnostics back on track
Full report: A full diagnostic: Cancer Research UK’s position on diagnostic services and cancer in England
E-cigarettes and harm reduction: An evidence review – RCP
The Royal College of Physicians (RCP) – April 2024
The Royal College of Physicians (RCP) has published a new report that looks at the part e-cigarettes can play in preventing death, disability and inequalities from tobacco use.
The new RCP report, E-cigarettes and harm reduction: An evidence review, looks at several themes, including how e-cigarettes can be used to support more people to make quit attempts while discouraging young people and never-smokers from taking up e-cigarette use. It also examines trends in tobacco and vaping use, the effectiveness of e-cigarettes to treat tobacco addiction, and the differences in health effects of vaping in people who smoke, vape or do neither, the role of the tobacco industry in the rising use of e-cigarettes, and the ethical dilemmas presented by e-cigarettes.
With over 50 recommendations, the report concludes that e-cigarettes remain an important tool to alleviate the burden of tobacco use but that much more can and should be done to reduce their appeal, availability and affordability to people who do not smoke, including children and young people, and reduce environmental harms.
It makes several recommendations for regulations on vaping to protect young people and never smokers from vaping:
- Price – raising their price by introducing an excise tax and minimum unit pricing while banning multi-buy purchases but making sure they remain a less expensive option for adults using them to quit smoking.
- Promotion – restricting ‘point of sale’ in store promotional materials and product visibility, and restricting promotion on social media.
- Purchase – ensuring Trading Standards services are sufficiently resourced to effectively enforce e-cigarette sales legislation and reduce underage sales.
- Products – making products less appealing to young people by introducing standardised packaging and flavour descriptors. Require manufacturers to limit the production of toxic substances from vapes, require the Medicines and Healthcare products Regulatory Agency (MHRA) to independently verify product contents, provide advice to consumers on which are the safest products if using them to stop smoking and require manufacturers cover the costs of recycling.
Read the report – E-cigarettes and harm reduction – full report
Gynaecological cancer – RCR consensus statements
RCR – April 2024
The RCR consensus process was initially developed in 2016 to help reduce variation in UK radiotherapy practice. The gynaecological cancer consensus statements should serve as a practical stimulus for gynaecological cancer teams to review their current radiotherapy service to ensure that they are able to deliver optimal treatment for their patients. They should be adopted in parallel with relevant National Institute for Health and Care Excellence (NICE) guidance.
These areas are covered by the consensus statements:
- Image guided and adaptive radiotherapy (IG-ART) for mobile gynaecological targets
- Brachytherapy
- Imaging and follow up including late effects
- Reirradiation of gynaecological cancers
- Molecular testing and sentinel lymph node assessment in endometrial cancer
Further information – Gynaecological cancer RCR consensus statements
Is cancer diagnosis veering off course?
Nuffield Trust – April 2024
There were nearly 330,000 new cancer diagnoses in England in 2021 – that’s more than 900 people a day finding out that they have a disease which is one of the most common causes of death in England.
Further information – Is cancer diagnosis veering off course?
Gynaecological cancer RCR consensus statements
RCR – Spring 2024
The RCR consensus process was initially developed in 2016 to help reduce variation in UK radiotherapy practice. The gynaecological cancer consensus statements should serve as a practical stimulus for gynaecological cancer teams to review their current radiotherapy service to ensure that they are able to deliver optimal treatment for their patients. They should be adopted in parallel with relevant National Institute for Health and Care Excellence (NICE) guidance.
These areas are covered by the consensus statements:
- Image guided and adaptive radiotherapy (IG-ART) for mobile gynaecological targets
- Brachytherapy
- Imaging and follow up including late effects
- Reirradiation of gynaecological cancers
- Molecular testing and sentinel lymph node assessment in endometrial cancer
Further information – Gynaecological cancer consensus statements
Career and Education Framework for specialist nurses working in the field of long-term follow-up and late effects for children and young people after cancer V2.0
Children’s Cancer and Leukaemia (CCLG) – April 2024
An important resource designed to support nurses who work in the field of long-term follow-up and late effects for children and young people after cancer has been updated and expanded.
Experts from the Children’s Cancer and Leukaemia (CCLG)/Teenagers and Young Adults with Cancer (TYAC) working group, Children’s After Cure Nurses (CANUK), have published the second edition ‘Career and Education Framework for specialist nurses working in the field of long-term follow-up and late effects for children and young people after cancer’.
This work represents a significant review of competencies and career progression for highly specialised nurses working in this field. It builds on original work that was developed by the National Cancer Survivorship Initiative in 2011 and has been brought up to date with current practice in the field of late effects and long-term follow-up (LTFU).
Download the framework – Revised career and education framework launched for long-term follow-up nurses
GIRFT guidance aims to improve diagnosis and treatment times for men with suspected prostate cancer
GIRFT – 10th April 2024
Best practice guidance to help improve the care of patients with suspected prostate cancer is now available to NHS colleagues in a new Getting It Right First Time (GIRFT) resource.
The practical guidance, supported by the British Association of Urological Surgeons (BAUS) and the British Association of Urological Nurses (BAUN), includes a delivery checklist and detailed principles for first-class care across the entire patient pathway – from primary care to secondary care to ongoing monitoring, as well as recommendations for managing biopsies and treatment choices.
Towards Better Diagnosis & Management of Suspected Prostate Cancer has been developed by an expert working group of 20 clinicians to ensure representation across the whole pathway.
Best practice recommended in the guidance aims to speed up the time to diagnosis and treatment, at the same time as reducing unnecessary tests. For example, in primary care the guidance acknowledges that men at higher risk (aged 50 or Black men over 45) can have a prostate-specific antigen (PSA) test after discussion of prostate cancer risk, with no digital rectal examination (DRE) needed if the PSA is raised. In secondary care, it recommends that patients who are fit for radical treatment should go direct to MRI and then have a review with the clinical team with the MRI result, helping to reduce delays to diagnosis and treatment if required.
Read the guidance – Towards Better Diagnosis & Management of Suspected Prostate Cancer
National Lung Cancer Audit (NLCA) State of the Nation report
HQIP – 10th April 2024
The National Lung Cancer Audit (NLCA), which is part of the National Cancer Audit Collaborating Centre (NatCan), has published a new report on the care received by patients diagnosed with lung cancer in England and Wales during 2022. It found that curative treatment rates for patients with early-stage lung cancer have been maintained (at 78% in England; 76% in Wales), despite the growth in demand due to an increase in early-stage presentations. More specifically, the proportion of patients diagnosed with stage I/II lung cancer has increased; in England, the proportion rose to 33.8% in 2022 compared to 30.5% in 2021 and 30.2% in 2019.
However, the report also states that several areas of care require significant improvement. Unlike most treatment metrics, the proportion of patients who had a lung resection has still not returned to pre-pandemic levels, although more patients had surgery in 2022 than 2021. Bed capacity issues may have been a contributing factor to this indicator not yet returning to 2019 levels and, as such, a call is made for providers to ensure that they have capacity to meet both current and future demand.
Other findings include:
- Time from diagnosis to treatment has worsened (in England, the median time was 41 days)
- Performance could be improved in relation to patients with stage IIIA non-small cell lung cancer (NSCLC) and good performance status being offered curative intent treatment, as well as for patients with advanced disease and good performance status receiving systemic anti-cancer therapy
- A third of patients are still being diagnosed after presenting via the emergency route, and there is marked geographical variation in these rates.
This report goes on to state that data completeness also requires improvement, particularly ‘smoking status’, and ‘seen by lung cancer CNS’ in the English Rapid Cancer Registration Dataset. It also underlines the importance of NHS trusts using the ‘route to diagnosis’ data item to record patients diagnosed after screening by the targeted Lung Health Check (TLHC) programme, saying: “Good quality data on the route to diagnosis is essential for the impact of screening on outcomes to be evaluated.”
Read the report – National Lung Cancer Audit (NLCA) State of the Nation report
Endocrine health in survivors of adult-onset cancer
The Lancet Diabetes & Endocrinology – 8th April 2024
This review highlights common symptoms and conditions related to endocrine disorders in this cohort, provides a summary of currently available practice guidelines, including medication use, and proposes a practical approach to diagnose affected patients in this group.
1,000 voices not 1: a report highlighting differences in cancer care in the UK
Bristol Myers Squibb
To form the foundations of the Cancer Equals campaign (which aims to understand and help address the many factors leading to delays to diagnosis and differences in experiences of cancer across the UK), Bristol Myers Squibb carried out quantitative and qualitative research in partnership with Shine Cancer Support. This research report highlights some of the challenges that people living with cancer are facing and the inequalities that exist in how cancer is experienced across the UK.
Read the report – 1,000 voices not 1: a report highlighting differences in cancer care in the UK
Cancer Services News 