Early cancer detection and survival to be prioritised by NHS

Monitoring one-year survival will be central to measuring progress in transforming cancer care, the Health and Social Care Secretary has announced.

Screening programmes will be overhauled and diagnosis made faster and more accurate with new state-of-the-art technology as part of a blueprint for rapidly improving cancer detection and survival the Health and Social Care Secretary Matt Hancock has announced.

Speaking in the House of Commons, the Health and Social Care Secretary set out how the NHS will deliver on its commitments to improve early detection of cancer.

In January, the NHS Long Term Plan set the ambition for three-quarters of all cancers to be detected at an early stage and 55,000 more people surviving cancer for 5 years each year by 2028. The Implementation Framework, agreed by the NHS, provides a blueprint for how this will be achieved at a local level. The one-year metric will be used to measure progress.

Steps in the framework include:

  • a radical overhaul of screening programmes
  • new state-of-the-art technology to make diagnosis faster and more accurate
  • more investment in research and innovation
  • the roll-out of new Rapid Diagnostic Centres across the country, building on the success of a pilot scheme with Cancer Resarch UK
  • NHS England extending lung health checks, targeting areas with the lowest survival rates
  • Health Education England increasing the cancer workforce, which will lead to 400 clinical endoscopists and 300 reporting radiographers by 2021

The document sets out the framework through which each of the 300 commitments in the Long Term Plan will be delivered – including the 20 headline commitments – as well as how government will monitor and support systems at a local level.

Full detail at Department of Health and Social Care

NHS England publishes Combined Performance Summary

NHS England has published its Combined Performance Summary, which provides data on key performance measures for January and February of this year. Here Jessica Morris of the Nuffield Trust shows some of these statistics and how they compare with previous years.

Commenting on the latest Combined Performance Summary, Prof John Appleby says the A&E slump and spike in cancer waits are of real concern and a reminder of the pressure that NHS staff face: A&E slump and spike in cancer waits mean stormy waters for new NHS targets

Full analysis: Combined Performance Summary: January – February 2019 | Nuffield Trust

The NHS England resource contains a summary of the performance statistics on:

Urgent and emergency care

Planned care

Cancer

Mental Health

Full detail: Combined Performance Summary | NHS England

Cancer survival in England: national estimates for patients followed up to 2017

Office for National Statistics | January 2019 | Cancer survival in England: national estimates for patients followed up to 2017

The latest release of Cancer survival in England: national estimates for patients followed up to 2017 has been published by the Office for National Statistics.

Main points

  • For the first time we have been able to produce robust 1-year and 5-year net cancer survival estimates by stage at diagnosis based on five years’ worth of cancer diagnoses (2012 to 2016), making them comparable with the adult cancer survival estimates.
  • Adults diagnosed at stage 1 with either melanoma of the skin, prostate or breast (women only) cancer have the same chance of surviving 1-year after diagnosis as an individual in the general population.
  • Melanoma of the skin had the highest net-survival estimate for 1-year survival in both men (97.4%) and women (98.6%) and for 5-year survival in both men (89.2%) and women (93.9%).
  • Pancreatic cancer had the lowest net-survival estimate for 1-year survival in men (23.7%) and women (25.3%) and for 5-year survival in both men (6.4%) and women (7.5%).
  • Predicted 10-year survival was also highest for melanoma of the skin for both men and women at 85.0% and 90.9% respectively, and lowest for lung cancer for both men and women at 7.0% and 10.6% respectively.

Sarah Caul, Head of Cancer Analysis, said:

“In general, we have seen an increase in people’s chances of survival across different types of cancer since our estimates for 2006 to 2010. Melanoma of the skin, prostate and breast cancer have continued to have the highest chances of survival across all age-standardised estimates compared to other cancer types. The higher survival figures could partly be explained by a high percentage of prostate and breast cancer patients being diagnosed at an earlier stage”

Cancer survival in England: national estimates for patients followed up to 2017

Read online at ONS

In the news:

BBC News ‘High’ survival for many cancers diagnosed at stages 1-3

Quality of Life in Long-term Cancer Survivors: Implications for Future Health Technology Assessments in Oncology

Office of Health Economics | July 2018 | Quality of Life in Long-term Cancer Survivors: Implications for Future Health Technology Assessments in Oncology

The Office of Health Economics has undertaken a literature review which  examines whether there is evidence to support the assumption that the quality of life (QoL) of  long-term cancer survivors (LTCS) can be similar to that of age-/sex-matched population samples.  The review included 20 papers which represented  23 studies covering a range of cancers, with the LTCS in the studies were more likely to have experienced early-stage cancer relative to late-stage cancer (Source: Office of Health Economics).

The news release is available from the Office of Health Economics 

The literature review can be downloaded from the OHE

Cancer survival trends

Little evidence for any direct impact of national cancer policies on short-term survival in England and no evidence for a reduction in socioeconomic inequalities in cancer survival. Findings emphasise that socioeconomic inequalities in survival remain a major public health problem. |  London School of Hygiene & Tropical Medicine | British Medical Journal

New research from the London School of Hygiene and Tropical Medicine found that despite overall improvements in cancer survival, the gap in survival between the most affluent and most deprived groups of patients remains unchanged for most cancers.

Survival trends were examined for 21 cancers in men and 20 cancers in women.

For each cancer, the chances of survival at one year after diagnosis were estimated separately for men and women in five levels of socio-economic deprivation, from the most affluent to the most deprived, and in each of the three calendar periods.

Researchers focused on one-year survival because most of the inequalities in cancer survival in England arise shortly after diagnosis. The survival estimates were corrected for the risk of dying from other causes of death. Estimates were also adjusted for differences in the age profile of cancer patients between men and women, and over time.

The “deprivation gap” in survival between the most affluent and most deprived groups of patients remained unchanged for most cancers. There was a clear and persistent pattern of lower survival among more deprived patients. It narrowed slightly for some cancers, where one-year survival was already more than 65% in 1996, such as cervical cancer and skin melanoma in men. By contrast, the deprivation gap in survival widened between the late 1990s and 2013 for brain tumours in men and lung cancer in women.

Full story at London School of Hygiene and Tropical Medicine

Link to the research: Aimilia Exarchakou et al.  (2018). Impact of national cancer policies on cancer survival trends and socioeconomic inequalities in England, 1996-2013: population based study. BMJ.

Prevention of bowel cancer

Bowel Cancer UK has published Finding the Key to the Cures: a plan to end bowel cancer by 2050.

Bowel cancer is the UK’s second biggest cancer killer with 16,000 people dying from the disease, and the fourth most common cancer with over 41,200 people diagnosed each year. The key to reducing the numbers of people dying from this condition is early diagnosis. This report examines ways and methods of increasing earlier detection methods which could transform survival rates and ultimately benefit thousands of people in the future.  

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.

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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.