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The report mentions the launch of the NHS Cancer Plan in 2000, the first comprehensive national strategy to improve cancer care in England. The plan stated that cancer patients in England had a lower survival than other European countries and promised that "by 2010, our five-year cancer survival rates will compare to the best in Europe".
The report finds that progress has been made in reducing mortality and improving the chances of survival and care experience for Englishmen with cancer.
Despite persistent ambitions to be the best in Europe and worldwide, as shown by successive cancer control strategies, the gap in survival rates has not been bridged. For example, a person diagnosed with colon cancer in the UK has a 60% chance of survival after five years, compared to 71% for people living in Australia.
Early detection and diagnosis of cancer is essential to improve a person's chances of survival because early-stage cancer responds better to treatment than advanced cancer. The five-year survival of bowel cancer is greater than 90% if it is detected early, but less than 10% if diagnosed late.
However, the proportion of people diagnosed with cancer at an early stage remained almost static between 2015 and 2017. In August, Public Health England released data that illustrates how cancer patients' diagnosis can affect their cancer options. treatment. This was followed by a Reform research that explored the benefits of using data to personalize cancer care.
Bridging this gap will require dramatic improvements in early diagnosis and cancer screening. The NHS will have to invest significantly in strengthening diagnostic equipment and manpower. Although recent investments have been made in cancer treatment equipment, the UK is far behind the number of diagnostic equipment available per person, ranking 35th out of 37 countries for CT scanners and at the 31st rank for MRI scanners. There is also a shortage of staff to operate the machines and report the results of the badysis, resulting in delays in diagnosis and treatment.
More needs to be done to help the public understand the symptoms badociated with cancer so that it can ask for help sooner. It is also essential that primary care has the resources to meet the demand for appointments. Research has shown that patients in England are more reluctant to disturb their GP than people living in other countries. In 2017, Cancer Research UK found that 22% of respondents feared losing their work time and 45% said it was difficult for them to make an appointment.
GPs should benefit from increased support to refer more patients to urgent investigation, as well as additional staff and equipment in hospitals to meet baseline demand. In the past, efforts to encourage GPs to pre-screen suspected cancer were hampered by resistance from commissioners under pressure to limit referrals and the limited ability of hospitals to meet the demand for diagnostic tests such as as endoscopy.
Improving early diagnosis and reducing the survival gap will require creating momentum and fostering collaboration between primary and secondary care to reduce waiting times and reduce the risk of illness. improve the treatment.
Our report revealed that disruptions caused by the 2012 Health and Social Services Act resulted in a loss of speed that was only recently rebuilt. It is essential that clinicians and local managers receive support to work beyond the borders of the organization to improve care, share experience and improve the quality of life. acquire skills in improvement.
To improve performance, results and survival rates, the report also recommends:
diagnostics
- Measures to improve screening for bowel cancer, including the introduction of primary care tests for patients with low-risk colorectal symptoms and the increase of non-medical endoscopy staff.
- Offers low-dose periodic CT scans for people at risk for lung cancer, an intervention that has reduced lung cancer mortality by 26%.
- Accelerated piloting and badessment of rapid diagnostic centers, which allow general practitioners to refer patients with potential cancer so that they are badessed and diagnosed in one day instead of multiple weeks or months.
The references
- More funding and support for GPs to allow for the investigation of patients with symptoms indicating a cancer risk greater than or equal to 3%, as recommended by the National Institute of Health and Care Excellence guidelines.
Prevention
- Investment in prevention, which will require reversing budget cuts in public health, as well as whole-of-government efforts to address the causes of obesity, smoking and over-consumption Alcohol, all known to cause cancer.
Responsibility
- Ensure clarity of NHS organizations responsible for making progress in early diagnosis at the national and local levels, with regular activity reports using key metrics, including: adoption of screening and results; number of referrals; stage of cancer at the time of diagnosis; and number of emergency presentations.
Professor Sir Mike Richards, former National Cancer Director, said: "The 2000 NHS Cancer Plan and all subsequent cancer control strategies have the ambition to give England the ambitions to compete with the best in Europe and around the world in cancer survival. Although many aspects of cancer have progressed, these goals have not been met. Every year, thousands of deaths could be prevented if we achieved these goals. This equates to a big carrier of people falling from the sky every two weeks.
"The ambitious goal of the Prime Minister to increase the number of early cancer screenings, which now ranges from one in two to three in four people by 2028, is welcome. However, if we seriously want to go to the face of early diagnosis, we will set goals and distribute money. not enough. The NHS needs to change the way care is currently organized to facilitate people's visualization and diagnosis as quickly as possible because we know it gives them the best chance of survival. "
Ruth Thorlby, Assistant Director of Policy at the Health Foundation, said, "Our report highlights the importance of the infrastructure to be put in place to engage and badist clinicians and managers to improve a complex service. such as cancer. The 2012 Health and Social Protection Act caused profound disruption, which was compounded by financial pressures. Although investments are clearly needed in the workforce and equipment, the experience of the last twenty years in the field of oncology shows that staff needs support, evidence and skills to implement the change. Without this, the injection of resources will not be effective on its own. "
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