Cancer Awareness and Early Diagnosis

In recent years there has been significant academic and media attention focused on the poor health outcomes of England when compared to other European countries.  Health outcomes for cancer can be measured in a variety of ways; however, the most common measures are survival rates.  Survival rates measure the proportion of patients with a disease that are still alive after a given time period. The NHS tends to focus on 1 year and 5 year survival statistics, particularly when making international comparisons. 

To put this in context, the national strategy document Improving Outcomes: A Strategy for Cancer says:

“If England was to achieve cancer survival rates at the European average, then 5,000 lives would be saved every year. If England was to achieve cancer survival rates at the European best, then 10,000 lives would be saved every year. That is our challenge.”

The differences in 1 year survival are of particular interest to us as they are used as the best available indicator of delays in getting a patient to diagnosis.  These delays can be associated with either patient delays – through a lack of awareness of the signs and symptoms of cancer, or a reluctance to seek medical help; or primary care delays – through poor access to diagnostic services or poor referral pathways to secondary care.

Interventions – What can be done to improve survival ?

The National Awareness and Early Diagnosis Initiative (NAEDI)  is a coordinated programme of work which aims to support local Cancer Networks and their constituent organisations in undertaking interventions aimed at:

• raising public awareness of the early signs and symptoms of cancer and encouraging the public to seek medical attention as soon as these symptoms arise 
• raising public awareness and uptake of the national screening programmes  for breast, bowel  and cervical cancer
• supporting primary care staff, particularly those in general practice in making prompt referrals  for the earlier diagnosis of cancer.

The ultimate aim of this initiative is to improve patient survival and outcomes once diagnosed.

The Cancer Network is committed to improving early diagnosis within our area.  There are currently a range of local projects focusing on the delivery of this aim:

• Women to Women Project
• Lung Cancer Awareness Project
• GP Profiles
• HIEC GP Education
• Primary Care Emergency Presentation Audit
•  Women to Women Project

See below for more detail on some of the projects:

• Dissemination of the Cancer Awareness Toolkit – aimed at non clinical staff
• Shared  learning from the
  • Woman to Woman Project  - aimed at raising awareness and uptake of the breast and cervical screening programmes
  • Cancer Awareness Project aimed at raising cancer awareness in South Asian populations
  • Check it out bus – aimed at encouraging lifestyle changes in men
  • Support  by various national charities’ campaigns 
    • E.g. SunSmart - run by Cancer Research UK

Locally, the following support has been provided for general practice  to  improve the early diagnosis of cancer:

• Practice Profiles -  comparative early detection and diagnosis information at a General Practice level, intended to assist primary care in clinical practice and service delivery.
• Cancer Audit of patients diagnosed via the emergency route as opposed to the managed route
• General Practice education events