Bowel cancer screening

Public Health England is calling on all men and women, aged over 60, to get screened for bowel cancer after the latest figures show over 40% are not getting tested. Embarrassment over providing a stool sample is one of the reasons, among men in particular, behind thousands being unnecessarily at risk of dying.

Bowel cancer screening is offered to all men and women aged 60 to 74, who are sent a home test kit to provide stool samples.  There were over 3,000 bowel cancers diagnosed as a result of screening in 2016 to 2017. In over 90% of these cases, cancers were found at an early stage, where treatment is more likely to be successful.

Image source: http://www.gov.uk

Bowel cancer is the fourth most common cancer in England, but the second leading cause of cancer deaths, with around 13,000 people dying from it every year.

If detected early, bowel cancer is very treatable which is why screening is vital and it has been shown to reduce the risk of dying from bowel cancer by 16%.

The latest NHS Screening Programmes in England annual report details the progress and activities of the NHS population screening programmes.

PHE press release: Men and women asked not to miss out on bowel screening

NHS England action to save lives by catching more cancers early

NHS England announces the scaling up of an innovative scheme that catches lung cancer early by scanning patients, along with new details of a more sensitive bowel cancer test that could save thousands of lives.

NHS England is now funding scanners in other areas as part of a national programme to diagnose cancer earlier, improve the care for those living with cancer and ensure each cancer patient gets the right care for them. This follows the success of the Manchester scanner scheme, where mobile scanners are detecting four out of five cases of lung cancer in the early stages when it is easier to treat. The mobile scanning trucks have picked up one cancer for every 33 patients scanned over the course of a year.

Plans for ‘FIT’, a more sensitive bowel cancer test that could see as many as 1,500 more cancer caught earlier every year have also been confirmed.

‘FIT’ is an easy to use home testing kit which predicts bowel cancer, following the introduction of the test almost a third of a million more people are expected to complete screening. The sensitivity level determines the number of people who should go on for further cancer testing.

 

NICE approves breakthrough breast cancer drugs

NICE confirms that it will recommend that breakthrough cancer drugs palbociclib and ribociclib be provided on the NHS for women with advanced breast cancer| story via OnMedica

There are around 45,000 new diagnosis of breast cancer each year in England and it is estimated that around 8,000 of these people would be eligible for treatment with either palbociclib or ribociclib.

In draft guidance, NICE said breast cancer patients should have routine access to these two life extending drugs after a new deal with their manufacturing companies who agreed to lower the price and who gave more evidence for their effectiveness.

Palbociclib (Ibrance) from Pfizer and ribociclib (Kisqali) from Norvatis, are recommended for people with hormone receptor (HR) positive, HER2 negative locally advanced or secondary breast cancer.

NICE said that although there were some uncertainties on how long they extend the life expectancy of people with this type of breast cancer, these promising new drugs were found to stall the growth of cancer for an extra 10 months on average.

• More information at NICE
• Full story via OnMedica
• Related: Thousands to benefit as ‘breakthrough’ breast cancer drugs approved for NHS use | The Guardian

UK has 6th highest rate of obesity – OECD

Health at a Glance 2017: OECD Indicators | Organisation for Economic Cooperation and Development | OnMedica

A report from the Organisation for Economic Cooperation and Development (OECD) has found that the UK has the sixth highest rate of adult obesity. The report looks at health indicators across its 100 member countries.

It shows that almost 27% of the adult population of the UK is obese, compared with the OECD average of 19.4%. The UK has a smoking prevalence of 16.1%, which is below the OECD average of 18.4%.

However average alcohol consumption per UK adult is higher than the OECD average, with consumption averaging at 9.5 litres per adult.

The report highlights cancer by way of an example of both the good progress made and continuing challenges. Cancer survival has improved over time, due in part to high screening rates. Breast and rectal cancer survival rates are now slightly higher than the OECD average, with, respectively, 85.6% and 62.5% of people diagnosed living for at least a further five years, versus 85% and 61% in the OECD as a whole. Both rose at a faster pace than average over the course of ten years. But bowel cancer survival is still below the OECD average (60% compared to 62.8%), and overall cancer mortality rates remain relatively high (222 deaths per 100 000 people, compared with an OECD average of 204).

Full document: Health at a glance 2017 – OECD indicators.

Breast cancer can return 20 years after treatment

Risk of certain breast cancers coming back remains for at least 20 years after treatment | New England Journal of Medicine | Story via Cancer Research UK

Research, carried out by The Early Breast Cancer Trialists’ Collaborative Group collected data from more than 60,000 women who had been diagnosed with hormone sensitive breast cancer (usually called oestrogen receptor positive or ER+ breast cancer) between 1976 and 2011.

All of the patients were given a type of anti-oestrogen therapy for five years as part of their treatment. At the five year mark the women had no signs that their breast cancer had come back and treatment ended.

The figures, published in the New England Journal of Medicine show that out of the women included in the study, 11,000 had their cancer come back in another part of the body such as the bone, liver and lung in the 15 years after stopping treatment. They also showed that the risk of cancer coming back remained the same year on year from when they stopped taking the anti-oestrogen drugs to 15 years later.

Full story at Cancer Research UK

Full reference: Pan, H. et al. (2017) 20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years. New England Journal of Medicine.

 

HPV jab reduces number of smear tests needed over lifetime

Researchers say three cervical screenings could offer same benefit to women given the human papillomavirus (HPV) vaccine as the 12 currently offered. | International Journal of Cancer | Cancer Research UK

Women who have been given the human papillomavirus (HPV) vaccine may only need three cervical screenings in their lifetime, a study has said. Researchers found that smear tests at the ages of 30, 40 and 55 could offer the same benefit to vaccinated women as the 12 currently offered.

The results are based on how the HPV vaccine and the improved cervical screening programme will work best together. The new programme called HPV primary testing is set to be introduced in England by December 2019. It means that cervical samples are tested for HPV but only checked for abnormal cells if the virus is found. The current test checks for abnormalities first, which is less efficient.

The Cancer Research UK-funded team at Queen Mary University of London said that cutting the number of screenings for vaccinated women could save the NHS time and money.

Full reference: Landy et al. |What cervical screening is appropriate for women who have been vaccinated against high risk HPV? A simulation study. | International Journal of Cancer

See also:

• Cancer Research UK Press release
• The HPV vaccine and cervical screening: how many tests do you need?

Cervical screening coverage rates in England fall

This report presents information about the NHS Cervical Screening Programme in England in 2016-17. It includes data on the call and recall system, on screening samples examined by pathology laboratories and on referrals to colposcopy clinics | NHS Digital

Key Facts:

• At 31 March 2017, the percentage of eligible women (aged 25 to 64) who were recorded as screened adequately within the specified period was 72.0 per cent. This compares with 72.7 per cent at 31 March 2016 and 75.4 per cent at 31 March 2012.

• A total of 4.45 million women aged 25 to 64 were invited for screening in 2016-17, representing an increase of 5.6 per cent from 2015-16 when 4.21 million women were invited.

• In total, 3.18 million women aged 25 to 64 years were tested in 2016-17, an increase of 2.9 per cent from 2015-16 when 3.09 million women were tested.

• Of samples submitted by GPs and NHS Community Clinics, 94.8 per cent of test results were returned Negative.

• 8.8 per cent of patients did not attend colposcopy appointments and gave no prior warning.

Full detail at NHS Digital: Cervical Screening Programme, England – 2016-17