New Quality standard: Oesophago-gastric cancer

This NICE quality standard covers assessing and managing oesophago-gastric cancer in adults. It describes high-quality care in priority areas for improvement.

Quality statements

Statement 1 Adults with oesophago-gastric cancer have access to an oesophago-gastric clinical nurse specialist.

Statement 2 Adults with oesophago-gastric cancer have their treatment reviewed by a multidisciplinary team that includes an oncologist and a specialist radiologist who both have an interest in oesophago-gastric cancer.

Statement 3 Adults with oesophageal or gastro-oesophageal junctional tumours (except T1a tumours) for whom radical treatment is suitable, have 18‑fluorodeoxyglucose positron emission tomography requested and reported within 1 week.

Statement 4 Adults with oesophago-gastric cancer have tailored specialist dietetic support before and after radical treatment.

Full detail: NICE | Oesophago-gastric cancer | Quality standard [QS176]

See also:  NICE interactive flowchart – Oesophageal and gastric cancer

Breast screening: leading a service

Information for local providers and commissioners on leading NHS breast screening services | Public Health England

This guidance sets out the principles for the organisation and leadership of local breast screening services.  The guidance is aimed at those who are responsible for making sure breast screening services are managed in a professional and effective way. This involves meeting agreed standards and continually striving to improve performance.

The guidance looks at the following areas:

1.Senior leadership team roles

2.Core management skills for the senior leadership team

3.Organisation of screening services

4.Breast screening service workforce

Full guidance: Breast screening: leading a service

The NHS breast screening programme (BSP) covers the screening pathway from identification of the eligible population to diagnosis of women with breast cancer.

Related content:  NHS breast screening (BSP) programme

NICE guideline: Brain tumours (primary) and brain metastases in adults

NICE | July 2018|Brain tumours (primary) and brain metastases in adults

NICE have published a guideline, it covers diagnosing, monitoring and managing any type of primary brain tumour or brain metastases in people aged 16 or over. It aims to improve diagnosis and care, including standardising the care people have, how information and support are provided, and palliative care.

This guideline includes recommendations on:

For full details see NICE 

Bowel cancer screening

Guidance for providers of bowel scope screening within the NHS Bowel Cancer Screening Programme in England | Public Health England

The UK National Screening Committee recommended the addition of bowel scope screening alongside the existing guaiac faecal occult blood test (gFOBT) following a clinical trial and 11 years of follow-up. These standard operating procedures (SOPs) help commissioners and providers in establishing and implementing bowel scope screening.

Full detail at Public Health England

Cancer screening: informed consent

Public Health England has updated the Cancer Screening: Informed consent guidelines.

These guidelines give commissioners, providers and healthcare professionals in cancer screening information on consent to screening and procedures.

The document covers information and advice on:

  • breast screening
  • cervical screening
  • bowel cancer screening
  • mental capacity and consent

It also provides several template letters for patients withdrawing from programmes.

Improving adherence to colorectal cancer surveillance guidelines

Mariko C. et al. (2017) BMC Cancer. 17:106

L0028329 Endoscopy operations. Colour lithograph by Virginia Powell,
Image source: Virginia Powell – Wellcome Images // CC BY-NC-ND 4.0

Background: Colorectal cancer (CRC) survivors are at increased risk of developing the disease again. Surveillance guidelines are aimed at maximising the early detection of recurring or new cancers and pre-cancerous polyps. The frequency and type of surveillance recommended depends on the type of treatment for the initial CRC, the extent of colonoscopic investigation prior to treatment and the results of previous surveillance tests. This paper aimed to test the effect of a paper–based educational intervention to improve adherence to colonoscopy following treatment for colorectal cancer.

Conclusions: Results indicate the paper-based educational intervention is not effective in improving adherence to colorectal cancer surveillance guidelines for colonoscopy.

Read the full article here

Adherence to cancer treatment guidelines

Heins, M.J. et al. European Journal of Public Health. Published online December 2016

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Background: Guideline adherence remains a challenge in clinical practice, despite guidelines’ ascribed potential to improve patient outcomes. We studied the level of adherence to recommendations from Dutch national cancer treatment guidelines, and the influence of general and cancer-specific guideline characteristics on adherence.

Conclusion: We found significant variation in adherence between different cancer treatment guidelines. While some guideline characteristics that seem to explain this variation may be considered difficult to modify, the potential for variance across cancer types and treatment modalities suggests that adherence could be further improved. At the same time, these results warrant tailored strategies for the improvement of adherence to clinical practice guidelines.

Read the full abstract here

Management of Early-stage Hodgkin Lymphoma: A Practice Guideline

Herst, J. et al. Clinical Oncology. Published online: September 30 2016

Highlights

  • A clinical practice guideline for early stage Hodgkin lymphoma is proposed.
  • The recommendations, based on a systematic review, have been reviewed by an external panel.
  • Evidence quality was evaluated with the Cochrane Risk of Bias tool and we used GRADE.
  • Combined modality therapy or chemotherapy alone are options for early-stage Hodgkin lymphoma.
  • PET scanning was not considered a good tool to identify patients for whom IFRT could be omitted.

Abstract

In the past, treatment for patients with early-stage Hodgkin lymphoma consisted mainly of radiotherapy. Now, chemotherapy alone and chemoradiotherapy are treatment options. These guidelines aim to provide recommendations on the optimal management of early-stage Hodgkin lymphoma.

We conducted a systematic review searching MEDLINE, EMBASE, the Cochrane Library and other literature sources from 2003 to 2015, and applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Two authors independently reviewed and selected studies, and appraised the evidence quality. The document underwent internal and external review by content, methodology experts, a patient representative and clinicians in Ontario.

We have issued recommendations for patients with classical Hodgkin lymphoma and with nodular lymphocyte predominant Hodgkin lymphoma; with favourable and unfavourable prognosis; and for the use of positron emission tomography to direct treatment. We have provided our interpretation of the evidence and considerations for implementation. Examples of recommendations are: ‘Patients with early-stage classical Hodgkin lymphoma should not be treated with radiotherapy alone’; ‘chemotherapy plus radiotherapy or chemotherapy alone are recommended treatment options for patients with early-stage non-bulky Hodgkin lymphoma’; ‘The Working Group does not recommend the use of a negative interim positron emission tomography scan alone to identify patients with early-stage Hodgkin lymphoma for whom radiotherapy can be omitted without a reduction in progression-free survival’.

Through the use of GRADE, recommendations were geared towards patient important outcomes and their strength reflected the available evidence and its interpretation from the patients’ point of view.

Read the abstract here