News from Around the Globe

Research is constant.  Every day we are learning more about how to fight cancer in all of its forms.  Here are the latest news articles from some of the leading cancer organizations.  Check back often to stay up to date.

news from around the world

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Stronger Than Cancer has shared these news articles for information purposes only.  It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

 

Examining equality in our grant giving

2 days 8 hours ago

Research Feature

As we launch the Cancer Research UK diversity data in grant funding report, some of our researchers and other leading voices in equality in research share their thoughts on where we are, what we are doing, and how we might do it better. 

At Cancer Research UK, we all share a common mission of beating cancer, and beating cancer means beating it for everyone. 

We’ve long felt that Cancer Research UK has a role to play in building a better research environment and when it comes to addressing systemic issues of underrepresentation in research, there is a lot of work to do. Having gathered information since 2017, we are reporting the diversity data for our funding schemes for the first time alongside our equality, diversity and inclusion (EDI) in research action plan. Both of these are part of our wider EDI strategy which aims to embed EDI across the whole charity.  

An important part of this journey is dialogue with our researchers and other leading voices in equality, diversity and inclusion. We want to listen in order to understand and address systemic inequalities to create the best environment for researchers to thrive. 
 

lynn_asante.png Dr Lynn Asante-Asare: “Adhering to practices that foster EDI needs to be part of a moral code of conduct for CRUK scientists.” 

If we are all judged by our scientific abilities alone, then we would not need to question why CRUK’s fellowships predominantly go to White researchers because funding would be allocated based on merit. But if, at the very beginning of our careers, some scientists are disadvantaged due to characteristics other than merit, then we must explore how these feed into the disproportionate allocation of funding amongst women, ethnic minorities, and those with disabilities. 

The ‘leaky pipeline’ describes the underrepresentation of women, compared to men, at different stages of the career ladder in academia. Fantastic progress has been made to tighten this pipe and I applaud the increase in membership of women and ethnic minorities on some of CRUK’s funding committees. CRUK attribute this to the introduction of stipulations and active recruitment, so similar approaches could be used to address the gender and racial imbalances seen at the earlier stages of the funding pipeline – such as through the creation of ring-fenced funding.  

Lack of success at the interview stage is a clear bottleneck for the progression of women and ethnic minorities through the funding pipeline. If this is due to applicant-dependent factors, then CRUK-wide initiatives around interview preparation are worth considering. Could more be done to mobilise the researchers aged 41 to 60 and above to support this without any conflicts of interest? As the most likely recipients of CRUK funding, dominating applications, allocated awards and committee positions, the report highlights this community as an exceptional source of experience and untapped potential for internal mentorship and coaching. To maximise progress in this area, EDI efforts, which are traditionally driven by early career women and ethnic minorities, should be better equalised across each age range, gender, race, and level of seniority. 

Lack of success at the interview stage is a clear bottleneck for the progression of women and ethnic minorities.

It may also be useful to include re-submission data in future reports. The ‘Matthew effect’ describes how those previously funded are viewed more favourably and dominate the pool of applicants for future funding rounds, in comparison to those who were unsuccessful. Are underrepresented researchers, who are the least successful in being awarded CRUK funding, less likely to reapply? There may also be a bottleneck here. 

If the disparities highlighted above are due to committee dependent factors, then initiatives focusing on changing the attitudes of those tasked with allocating funding are useful – such as bias training, and reverse mentoring. However, interventions that bypass one’s willingness to unlearn practices that reinforce barriers are equally important, such as anonymising applications, enforcing anti-bullying and harassment guidelines and agreeing to pledges. Adhering to practices that foster EDI, through the development and enforcement of relevant policies, needs to be part of a moral code of conduct for CRUK scientists. 

Reporting aggregated data for ethnic minorities can be misleading because this masks the inequalities that exist within individual groups, such as the grave underrepresentation of Black researchers. Therefore, targeted efforts to improve recruitment and retention of ethnic minority researchers should always be informed by trends seen within disaggregated individual groups, irrespective of any future improvements that may be observed in the overall aggregated data. 

Although difficult, it is time to challenge meritocracy and consider if the inequalities existing in society at large – gender discrimination, racism, ableism, to name but a few – are also reflected in our research community. This is why reporting funding data is so important, and I sincerely commend CRUK for going beyond simply reporting the data by including well thought out interventions. I have high hopes for our future as a research community.  

Lynn is a visiting scientist at the CRUK Cambridge Institute and is now completing her medical training at the University of Leicester. She is also a member of CRUK’s Equality, Diversity and Inclusion Advisory Board. 
 

chantelle_lewis.png paulette_williams.png Paulette Williams and Chantelle Lewis: “CRUK must be holistic, purposeful and radical if they are serious about addressing the variety of gendered and racialised inequities this report highlights.” 

The CRUK grant diversity report reads as a considerable move in the right direction for the organisation’s objectives to tackle the inequities and uneven outcomes published in this three-year data collection.  

As the largest global independent cancer research charity, and as leaders in the biosciences, CRUK are setting a constructive example for multiple sectors on the virtues of transparency on existing equality and diversity data.  

As is declared throughout the report, CRUK – like many others – are now beginning to acknowledge that inclusivity is essential to the mandate of their remit. With this, CRUK goals should now focus on improving delivery for the variety of researcher and staff populations, as well as aiming to better represent the patients in need of their research. 

This report also reads as a further exemplification of how far the research community more broadly must go to move towards equity within their differing recruitment and funding processes. As with the widening participation efforts that have been encouraged in the education and research communities for decades, CRUK must commit to policies that are long, medium and short term. Though the data reads as a familiar story – the implementation of such policies by CRUK must be holistic, purposeful and radical if they are serious about addressing the variety of gendered and racialised inequities this report highlights.  

At Leading Routes, we are clear that short-term policy initiatives such as positive action must be accompanied by an active and ongoing investment in cultural change within an organisation. For this reason, we would suggest that future reports consider the influence of CRUK management structures and decision makers outside of funding committees, on the cultures which clearly contribute to creating the conditions for the data published in this report. Also, the gendered and ethnic composition across all pay scales should be considered to ensure that CRUK is recognising the importance of inclusivity and career progression for all. This is important for the existing and potential employees, but more broadly is likely to have a positive impact on future funding decisions.  

Gendered and ethnic composition across all pay scales should be considered to ensure that CRUK is recognising the importance of inclusivity and career progression for all.

In future reports, CRUK should consider disaggregating the ethnicity data further; especially with the 'Asian' and 'Mixed' categories. We would also be encouraged to see data which incorporates a sub-analysis of ethnicity and gender combined. For example, the report identifies Black researchers as the most underrepresented group overall with no detail on gender, such as the proportion of Black Caribbean women researchers. Whilst small numbers compromise statistical significance, we would suggest that such debates do not detract from the real issue of very low representation.  

It remains essential for sector leaders to publish and report annually on their equality and diversity data; but for these to serve their purpose of tangible change and evolution for the given organisation, they must not continue to be an exercise in equality and diversity, but rather, a reminder of the work that needs to be done. These reports are a small starting point for the purposeful interventionalist policies that must follow.  

Paulette is founder and managing director of Leading Routes, an initiative that aims to prepare the next generation of Black academics. She is also an MA student at the Department for Psychosocial Studies at Birkbeck, University of London. 

Chantelle is deputy director of Leading Routes. She is also a researcher, sociologist and podcaster based at Goldsmith’s College. 
 

sophie_acton.png Dr Sophie Acton: “It’s really pleasing to see major funders like CRUK prioritising research culture and starting to address inequalities in research.” 

It is positive to see equal success rates between male and female applicants overall. It is also clear that CRUK has made conscious efforts to balance gender across its funding committees. These data also highlight efforts to further diversify committees with the inclusion of junior researchers on these panels.  

However, when looking closely at the data, there are some areas where differences still exist; female researchers and researchers from an ethnic minority background appear to be at a disadvantage. I noticed this particularly in the data referring to success at interview for fellowship awards. Although the cohorts presented here are reasonably small numbers of applicants, the proportion of ethnic minority applicants unsuccessful at interview stage was much higher than for White applicants. There is a similar pattern for female fellowship applicants compared to their male peers. It can be assumed that the proposals submitted were of equally high quality and received excellent feedback following peer review in order to be invited for interview. In my opinion, these data could point to either a lack of confidence or preparation for the interview or potentially unconscious bias at the in-person phase of the application process. CRUK could try to address this by encouraging all fellowship applicants to arrange practice interviews with their host institutions, and to provide clear guidance on the interview structure in advance to help all applicants to prepare and perform to the best of their ability.  

One other notable statistic is the reduction in female researchers funded by CRUK at senior levels through programme awards. In this case, there is not any clear difference in success rate but instead a reduction in applications received from female team leaders. It is possible that these researchers have been successfully funded from other sources, but I suspect that other funders would find a similar pattern in their own datasets. In that case, we must ask what has happened to those successful female fellowship holders, and what trajectory has their career taken following their fellowship awards? The data published here cannot answer that, but I would encourage CRUK to track the careers of their researchers to investigate further. CRUK could also proactively and directly encourage senior researchers from underrepresented groups to apply for programme awards.  

What has happened to those successful female fellowship holders, and what trajectory has their career taken following their fellowship awards?

As data continues to be collected, I would be interested to see further analysis comparing other factors such as total value of grants awarded along with personal salary levels requested, since other UK-wide data published recently suggests that female researchers may be disadvantaged in other more subtle ways.   

It’s really pleasing to see major funders like CRUK prioritising research culture and starting to address inequalities in research. These data are a benchmark to be used to pin-point where issues arise and to measure the effectiveness of new policies going forwards.   

Sophie is a CRUK fellow and junior group leader at the UCL Laboratory for Molecular Cell Biology (LMCB). She is also co-chair of LMCB’s Equality, Diversity and Inclusion Committee.    

 

Please do have a look at our diversity report and EDI in research action plan. We are really interested in not just your feedback on what we’re doing, but also your ideas about how we can work together to improve cancer research for everyone.  

If you want to get in contact, please do so at EDIinResearch@cancer.org.uk  

 

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Almost half of people with possible cancer symptoms didn’t see GP in first wave of pandemic

2 days 13 hours ago

News report

Nearly half of people who had potential cancer symptoms in the first wave of the COVID-19 pandemic did not contact their GP, a Cancer Research UK and Cardiff University study suggests.

Initial findings of the UK-wide survey, focusing on the experiences of 7,543 people from March to August 2020, found that possible cancer symptoms were common during the first wave, with 40% of people saying they had experienced at least one potential cancer symptom. 

People gave a variety of reasons for putting off seeking medical help, including not wanted to burden the NHS. 

Michelle Mitchell, Cancer Research UK’s chief executive, said that catching cancer at an early stage gives people the best possible chance of surviving the disease. “We’re extremely concerned people have put off seeking help for cancer symptoms, even if this was for the best of intentions.”

‘Concerning’ findings

Of those who experienced symptoms, 45% admitted to not contacting their GP for any symptom. People did not seek help even for ‘red flag symptoms’ – 31% of those who experienced coughing up blood, 41% of those who had an unexplained lump or swelling and 59% of those who noticed a change in the appearance of a mole did not contact their GP. 

More than two-thirds of participants reporting feeling safe from COVID-19 if they needed to attend an appointment at their GP or hospital, but nearly three quarters (72.3%) were worried about delayed cancer tests and investigations due to the pandemic. 

Worrying about wasting healthcare professionals’ time (15.4%), worrying about putting extra strain on the NHS (12.6%) and not wanting to be seen as someone who makes a fuss (12%) were some of the barriers reported. 

“Worryingly, we don’t yet know what the pandemic’s long-term impact on cancer stage and survival will be, so it’s vital people don’t delay contacting their GP if they notice any unusual changes to their body,” said Mitchell. 

"We want to hear from you"

In-depth  interviews with 30 people found that despite putting concerns on hold so as not to burden the NHS, they were pleased with the care received when they did contact their GP. They even wanted to keep remote GP consultations an option alongside face-to-face consultations.

And though there was fear or nervousness around attending primary care services and catching or passing on the virus at secondary care services, those who did attend either service face-to-face described feeling “safe” and “secure” when doing so.

Dr Neil Smith, Cancer Research UK’s GP adviser, said that GPs across the UK are doing everything they can to ensure people get the care they need. “So if you’ve noticed an unusual or persistent symptom, tell your doctor. We want to hear from you.”

In most cases it won’t be cancer, but if it is, catching it early gives someone the best chance of successful treatment. “For those who’ve been unable to get through to your doctor’s surgery, although it may be frustrating, I would encourage you to keep trying. GPs like me are still here to help you.”

To cater for the number of patients who require medical attention, the NHS will need to operate at pre-pandemic levels to ensure everyone gets seen. And as diagnostic times are already long, investment is needed to increase capacity and make sure people also get timely diagnosis and treatment. 

Michelle Mitchell said: “NHS staff have worked incredibly hard to manage the increased strain COVID-19 has put on an already stretched system but the government must protect cancer services if we’re to avoid the real possibility that cancer survival could go backwards for the first time in decades.”

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Key Takeaways on Organic Food

2 days 14 hours ago
I’m frequently asked for summaries on many different topics of interest. Your wish is my command. We have topic pages on more than a thousand […]

Antibiotic shows potential in helping treat aggressive blood cancer

3 days 3 hours ago

News report

A type of aggressive blood cancer could be made more sensitive to chemotherapy using an antibiotic currently available to treat diarrhoea, according to new research published today in Science Translational Medicine.

Funded by Cancer Research UK and Blood Cancer UK, the study looked to tackle a specific type of acute myeloid leukaemia (AML) that contains a genetic change known as MLL, by investigating the disease’s origins.

This type of leukaemia, often referred to as MLL-AML, has a particularly poor prognosis as it quickly becomes resistant to the standard chemotherapies used to treat it. Tackling this resistance is a major challenge in successfully treating the disease, as it can leave patients with no other options.

Michelle Mitchell, chief executive of Cancer Research UK, said: “Resistance to treatments is one of the biggest challenges facing cancer research, and learning that there are no other treatment options is understandably one of the worst things a patient could hear. This research demonstrates how unpicking the biology of cancer can lead to surprising discoveries, and that we may have a vast array of drugs already out there that could help boost the effects of current treatments.”

What is MLL-AML? Acute myeloid leukaemia is a diverse disease, with many different subtypes depending on the genetic mutations that drive it. This can affect how successfully the cancer can be treated, with some subtypes having a much poorer prognosis than others. MLL-AML is one of the worst, with just 1 in 4 patients surviving 2 to5 years or more. Read more about our research into AML. Delving into cancer’s origins

A big challenge for researchers has been understanding why some AMLs respond to treatment, while others become resistant. Early work in mice has pointed towards a cancer’s origins as being important, but confirming this in human cells has proved difficult. 

Led by Professor Eric So at King’s College London, researchers studied how MLL-AML develops in humans for the first time, by establishing a new way of modelling how the stem cells that form our blood could turn into AML when affected by the MLL genetic alteration.

It’s a gratifying moment for So in particular, who was involved in the initial work in mice almost two decades ago.

“Having worked on the research that shed light on the origins of MLL leukaemia in mice 18 years ago, this development is an important step forward for AML research and provides a new avenue to screen for and identify new targets to treat it,” said So.

Using the new approach, So and his team found that the disease could originate from 2 different types of cell, with one leading to more resistant disease than the other.

Studying the more resistant type in detail showed that it produced much more of a particular protein – ABCC3 – than the other, which could be responsible for making it more resistant to chemotherapy.

They confirmed this theory in human cells. When the team removed a cell’s ability to produce ABCC3, they were far more sensitive to chemotherapy.

Dr Fatima Sulaiman, head of research at Blood Cancer UK said: “This is exciting research which not only identifies the cells that might stop chemotherapy working in some people with AML, but also identifies a potential way to overcome this.

From diarrhoea to cancer

The next step for the team was to find a drug that could either stop ABCC3 from being made or prevent it from working. By looking into existing research, they found a recent paper that showed that fidaxomicin – an antibiotic currently prescribed to treat diarrhoea caused by the bacteria C. difficile – was effective at inhibiting ABCC3.

“It was both unexpected and, frankly, good fortune that there happened to be a recent study showing an already approved antibiotic could work for this research. It was the perfect candidate to test out,” said So.

Testing the drug on treatment resistant MLL-AML, the team found that it successfully sensitised the cancer to chemotherapy in both cells grown in the lab and in mice.

The researchers now want to test the effectiveness of fidaxomicin at helping to treat MLL-AML in a clinical trial. As fidaxomicin is already used to treat diarrhoea and has been shown to be safe, they hope that a trial could be set up relatively quickly and provide new hope for patients who would have no other options.

“We now need to see further studies testing this approach in people with AML to see how much benefit it could bring,” Sulaiman added.

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Opinion: ‘We need to increase testing in primary care’

3 days 13 hours ago

Science blog

Comment and opinion from Cancer Research UK’s community of experts. The opinions outlined in this article do not necessarily represent the views of Cancer Research UK.

The original cancer problem was that we weren’t testing smartly enough. When I became a GP over 30 years ago, we didn’t know well enough who of those walking through the doors to our GP surgeries could be harbouring cancer, so the big push was to be better at identifying the different levels of cancer risk associated with different symptoms and test results to inform who needed testing and who didn’t.

It feels like we’ve got there now – the guidance issued by the National Institute of Health and Care Excellence (NICE) in 2015 was the high citadel of testing smarter: the previous guidance in 2005 simply not having enough evidence behind its recommendations. The other paradigm-shifting in 2015 was the decision to give an explicit risk of cancer that warranted urgent testing – and in being ambitious in setting it as low as 3%. Even more liberal was encouraging GP testing at lower risks than 3%.

But if we stick to the 3% rule outlined in the NICE guidance – that you urgently refer or do tests only if someone’s symptoms equate to a 3% risk of cancer or greater, there will be some people that will never get testing and will end up presenting as an emergency. We will only be able to capture those people if we’re prepared to test more. We can only test more if we make it patient friendly and economically friendly. Both of those factors point towards stationing it closer to the patient – in general practice or on the high street.

This won’t work for all presentations I hasten to add – GPs will still need to refer patients to hospital for some tests. We don’t have the technology in primary care to do the tests for a woman with a breast lump, for example, so we need to get the experts involved. But there are many other cancers where you can move towards more testing outside of hospitals. Things like chest X-rays, blood counts, platelet counts, but also more sophisticated tests like CA125 or ultrasound to pick up potential ovarian cancer and in the future potentially blood tests that pick up cell-free DNA.

GPs are evolving

It’s a win-win. From a patient perspective – the closer to home you can do tests, the easier, more familiar, and hopefully nicer, it will be. It’s also likely to be cheaper, and you may get your results back quicker – because at least you’ve got your GP’s phone number.

The question is – are we blurring the line by moving more testing to primary care or community settings such as community diagnostic hubs recently recommended in Professor Sir Mike Richards’ review of diagnostic services? Some GPs may say yes, some specialists may say yes. It’s never going to be a unanimous decision – there are 40,000 GPs in the UK with I would imagine around 40,000 different opinions on the best way to deliver care.

But I would argue that the line has been blurring for years. Stretching the limits of primary care is a part of its history. The truth is primary care evolves, GP practices evolve. In time, practices that were inconceivable become the norm.

Take Faecal Immunochemical Testing (FIT). It was used only as part of bowel screening, but a few years ago NICE brought it in to test people who had low-risk symptoms below the threshold for referral for a colonoscopy for suspected bowel cancer, but where something might be going on that needed investigating. It wasn’t a popular decision at first – there was tremendous fear within the surgical community that using FIT in people with such symptoms would lead to an influx of patients without disease, which would overwhelm endoscopy services.

But the doomsayers missed two points that have turned out to be true. The first was, if someone had a positive FIT, they were no longer low risk, they became quite high risk – 11% of people who tested positive went on to be diagnosed with bowel cancer. The other point was they were lowering their threshold for testing anyway: ‘low-risk’ patients were being offered colonoscopies. Fair enough, as there was no other test. So bringing in FIT as a way of sifting in primary care actually reduced pressure on endoscopy services.

The icing on the cake

There are so many reasons why increasing testing is smart. Firstly, patients want it – if cancer is even a remote possibility people want to know. The other thing is, general practice is not simply painting by numbers. I don’t particularly like the phrase ‘gut feeling’, though intuition is a bit better. It’s experience: let’s call it the icing on the cake – the experience that helps a GP see something unusual, the classical ‘needle in the haystack’. Giving GPs more flexibility with how they can test will mean they can more easily navigate patients through the complex health system we have.

But can the NHS cope? We know the NHS is stretched – and cancer is an area where specialists are living with limitations to the number of personnel and equipment they have available. But as we’ve seen a number of times, moving testing into a community setting – be that in GP practices or future community diagnostic hubs – can help alleviate pressure by helping to identify people who do need further tests or treatment.

And when it comes to GPs, I think we can handle it. I’m not saying we need to test everyone who comes through the door – we are experts in managing risk. I’m talking about one or two patients a week that warrant a more liberal approach to testing, you do a test and then if it’s positive, you refer them on. That’s not rocket science.

Of course, with more testing we may find more things that aren’t cancer, which could contribute to increased anxiety and more demand on the health service. But if we are to shift outcomes for cancer the way UK Government says it wants to, we have to be proactive and go looking for cancer, not wait for it to come to us. By that time, it could be too late.

And now may be the perfect time. Before COVID-19, general practice was struggling to provide the highest quality care that we want to offer. My colleagues were sinking in a pile of paperwork, but also in their own successes – we’re keeping people in the UK alive for longer, and that means more people to see and more conditions to treat and manage.

It’s a strange thing to say, but COVID-19 might have saved general practice. It forced us to redesign and take stock. The wholesale switch to remote consulting has shown us that there are ways of dealing with patients’ problems that are acceptable. There’s a lot of debate around that and how we’ll work in the future, but I think it’s safe to say that we’ll never 100% switch back.

As always, we’re evolving – and a shift towards increased testing to further drive improvements in outcomes for patients should be a part of that.

About the author

Professor Willie Hamilton specialises in primary care diagnostics at the University of Exeter, with a particular expertise in cancer. He was clinical lead on the main NICE guidance ‘Referral for Suspected Cancer’ NG12, published in 2015, which have contributed to meeting the target of reducing the number of avoidable cancer deaths in the UK by 10,000. Hamilton and his team have also produced Risk Assessment Tools for all major adult cancers, providing the GP and patient with an accurate estimate of the risk of cancer when a patient reports symptoms to their GP.

Hamilton is a third generation doctor from Belfast.

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Over 100,000 Scotland patients in test backlog

4 days 11 hours ago

News report

Deeply concerning new figures released in Scotland show a backlog in the number of people waiting for diagnostic tests.

These latest figures show that around 101,000 patients in Scotland were waiting for a key diagnostic test at the end of December 2020, an increase of 15.3% on the same time last year.

Eight tests are considered in the Public Health Scotland report, including several that are relevant to the diagnosis of cancer.

The findings are set against a backdrop of severe NHS pressures due to the pandemic. It’s clear that urgent action has been needed to support cancer services – and this was acknowledged by the Scottish Government at the end of last year as part of its National Cancer Recovery Plan.

But the problems can’t all be attributed to COVID-19 service disruption.

The Scottish Government standard that no one should be waiting more than 6 weeks for a diagnostic test hasn’t been met since June 2010.

And while Cancer Research UK has been calling for action for many years to reduce the time people are waiting, progress remains slow, particularly when it comes to one of the main contributory factors – staff shortages.

To ensure that everyone gets the tests they need when they need them, we need to take a long-term view, to allow the time required to train and employ more of the health professionals involved in delivering and interpreting tests which can diagnose cancer. 

Elections in Scotland

In the next few months, political parties in Scotland will be publishing their manifestos ahead of the Holyrood Elections which are likely on May 6th. It’s a chance for them to consider how they could make a tangible difference to improving cancer survival by committing to a clear plan to deliver the number and type of staff required over the next decade.

“It’s hard to see how things will improve significantly unless long-standing staff shortages are addressed as a priority,” said Kirsty Slack, Cancer Research UK’s public affairs manager in Scotland.

Alongside the historic issues that have resulted in people waiting too long to receive a test and diagnosis, the pandemic has undoubtedly hit cancer services hard.

This was established late last year when Public Health Scotland reported that 4,000 fewer people in Scotland had a "pathologically confirmed" cancer diagnosis (where the cancer is diagnosed using a sample of tissue) than would have been expected between March and June 2020. 

 

  Pandemic recovery

Shortly after it emerged there had been a significant drop in cancer diagnoses, the Scottish Government published its National Cancer Recovery Plan. It was the first government in the UK to set out how it was going to support cancer services to recover from the pandemic. 

This plan is a positive step, setting out the Scottish Government’s actions to respond to COVID-19 in the context of cancer, redesigning and improving services over the next 2 and a half years. Included is an additional £17 million of funding for the health service, on top of an already committed £97.5m.

Over £5m will go towards improving the services that deliver diagnostic tests, with the lion’s share (£3 million) invested in the delivery of new Early Cancer Diagnostic Centres (ECDCs). These aim to create a fast-track service for those with a range of serious but non-specific symptoms, such as fatigue, weight loss and nausea which will be assessed and tested by a team of specialists during one visit.

But while the Recovery Plan recognises that the NHS workforce is under strain and proposes some positive actions to improve the situation in the short term, steps need to be taken to make sure Scotland’s NHS workforce is fit for the future.

These include:

  • Assessing and being clear on where there are bottlenecks in the workforce, setting out how many staff are needed to address both current and future demand. This includes publishing staffing figures across core cancer related professions.
  • Investing to recruit and retain staff in key disciplines.
  • Exploring the potential to upskill staff to deliver elements of diagnostic tests. For example, considering where technical staff can be more involved in processes such as dissection in pathology, rather than relying on consultants for every step.
  • Putting new digital innovations which can accelerate people’s diagnoses into practice. These can be simple solutions such as setting up digital networks allowing scans and other materials to be shared safely in an electronic way, rather than sending hard copies by post or courier. This can reduce the burden on clinicians in parts of the country where staffing shortages are more acute, as they can call on support from areas where the squeeze isn't as severe.

“Early diagnosis followed by swift access to the most effective treatment can give patients the best possible chance of beating cancer,” adds Slack. “The staff shortfall needs to be fixed quickly. But, realistically, it takes a long time to train diagnostic professionals from scratch and so any strategy to address the issue needs to take this into account."

In the meantime, it’s important that patients know the NHS is still open for business and staff are giving the best care they can. It’s essential that anyone who notices any changes to their body gets them checked out.

How to reduce waiting times is a complex issue and, as well as there not being enough skilled staff, we also need to see investment in kit to make the system more efficient. Staff are often reliant on outdated equipment and this can slow down how quickly patients receive their results. 

In the 1970s, less than a quarter of people with cancer survived their cancer. But over the last 40 years, survival has doubled – today half will survive their disease

Cancer Research UK’s ambition is to accelerate progress and see three-quarters of people surviving the disease within the next 20 years. Diagnosing more cancers earlier will be essential to achieving this ambition.

As we live longer lives, more of us will be diagnosed with cancer. So not only will the services dedicated to diagnosing cancer need to catch up now, continued improvements will be crucial if they’re to keep up with demand.

Read more

Around 101,000 Scotland patients in test backlog

4 days 11 hours ago

News report

Deeply concerning new figures released in Scotland show a backlog in the number of people waiting for diagnostic tests.

These latest figures show that around 101,000 patients in Scotland were waiting for a key diagnostic test at the end of December 2020, an increase of 15.3% on the same time last year.

Eight tests are considered in the Public Health Scotland report, including several that are relevant to the diagnosis of cancer.

The findings are set against a backdrop of severe NHS pressures due to the pandemic. It’s clear that urgent action has been needed to support cancer services – and this was acknowledged by the Scottish Government at the end of last year as part of its National Cancer Recovery Plan.

But the problems can’t all be attributed to COVID-19 service disruption.

The Scottish Government standard that no one should be waiting more than 6 weeks for a diagnostic test hasn’t been met since June 2010.

And while Cancer Research UK has been calling for action for many years to reduce the time people are waiting, progress remains slow, particularly when it comes to one of the main contributory factors – staff shortages.

To ensure that everyone gets the tests they need when they need them, we need to take a long-term view, to allow the time required to train and employ more of the health professionals involved in delivering and interpreting tests which can diagnose cancer. 

Elections in Scotland

In the next few months, political parties in Scotland will be publishing their manifestos ahead of the Holyrood Elections which are likely on May 6th. It’s a chance for them to consider how they could make a tangible difference to improving cancer survival by committing to a clear plan to deliver the number and type of staff required over the next decade.

“It’s hard to see how things will improve significantly unless long-standing staff shortages are addressed as a priority,” said Kirsty Slack, Cancer Research UK’s public affairs manager in Scotland.

Alongside the historic issues that have resulted in people waiting too long to receive a test and diagnosis, the pandemic has undoubtedly hit cancer services hard.

This was established late last year when Public Health Scotland reported that 4,000 fewer people in Scotland had a "pathologically confirmed" cancer diagnosis (where the cancer is diagnosed using a sample of tissue) than would have been expected between March and June 2020. 

 

  Pandemic recovery

Shortly after it emerged there had been a significant drop in cancer diagnoses, the Scottish Government published its National Cancer Recovery Plan. It was the first government in the UK to set out how it was going to support cancer services to recover from the pandemic. 

This plan is a positive step, setting out the Scottish Government’s actions to respond to COVID-19 in the context of cancer, redesigning and improving services over the next 2 and a half years. Included is an additional £17 million of funding for the health service, on top of an already committed £97.5m.

Over £5m will go towards improving the services that deliver diagnostic tests, with the lion’s share (£3 million) invested in the delivery of new Early Cancer Diagnostic Centres (ECDCs). These aim to create a fast-track service for those with a range of serious but non-specific symptoms, such as fatigue, weight loss and nausea which will be assessed and tested by a team of specialists during one visit.

But while the Recovery Plan recognises that the NHS workforce is under strain and proposes some positive actions to improve the situation in the short term, steps need to be taken to make sure Scotland’s NHS workforce is fit for the future.

These include:

  • Assessing and being clear on where there are bottlenecks in the workforce, setting out how many staff are needed to address both current and future demand. This includes publishing staffing figures across core cancer related professions.
  • Investing to recruit and retain staff in key disciplines.
  • Exploring the potential to upskill staff to deliver elements of diagnostic tests. For example, considering where technical staff can be more involved in processes such as dissection in pathology, rather than relying on consultants for every step.
  • Putting new digital innovations which can accelerate people’s diagnoses into practice. These can be simple solutions such as setting up digital networks allowing scans and other materials to be shared safely in an electronic way, rather than sending hard copies by post or courier. This can reduce the burden on clinicians in parts of the country where staffing shortages are more acute, as they can call on support from areas where the squeeze isn't as severe.

“Early diagnosis followed by swift access to the most effective treatment can give patients the best possible chance of beating cancer,” adds Slack. “The staff shortfall needs to be fixed quickly. But, realistically, it takes a long time to train diagnostic professionals from scratch and so any strategy to address the issue needs to take this into account."

In the meantime, it’s important that patients know the NHS is still open for business and staff are giving the best care they can. It’s essential that anyone who notices any changes to their body gets them checked out.

How to reduce waiting times is a complex issue and, as well as there not being enough skilled staff, we also need to see investment in kit to make the system more efficient. Staff are often reliant on outdated equipment and this can slow down how quickly patients receive their results. 

In the 1970s, less than a quarter of people with cancer survived their cancer. But over the last 40 years, survival has doubled – today half will survive their disease

Cancer Research UK’s ambition is to accelerate progress and see three-quarters of people surviving the disease within the next 20 years. Diagnosing more cancers earlier will be essential to achieving this ambition.

As we live longer lives, more of us will be diagnosed with cancer. So not only will the services dedicated to diagnosing cancer need to catch up now, continued improvements will be crucial if they’re to keep up with demand.

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