Sara Hiom (am) [Read-Only] - Cancer Research UK · 6olgh .: kwwsv skhvfuhhqlqj eorj jry xn zhuh...
Transcript of Sara Hiom (am) [Read-Only] - Cancer Research UK · 6olgh .: kwwsv skhvfuhhqlqj eorj jry xn zhuh...
Early Diagnosis: 10 years on
Sara HiomDirector of Early Diagnosis and Health Professional Engagement
Cancer Research UK 5th Biennial Early Diagnosis Research Conference11th – 13th February 2019Birmingham, UK
Recap from yesterdayMonday 11th FebruaryEarly Career Researchers: Showcase of research into early diagnosis
• Dr Katriina Whitaker and Dr Fiona Reddington (chairs)• Dr Paula Bradley• Dr Robert Kerrison• Dr Cathrine Wildenschild Nielsen• Dr Marije van Melle• Bethany Wickramasinghe• Hanna Skrobanski
Sharing insights: research and initiatives to improve public awareness and drive behaviourchange
• Professor Yoryos Lyratzopoulos (chair)• Carolynn Gildea• Katie Connor• Dr Monica Koo• Natalia Calanzani
Poster viewing and welcome reception
Tuesday 12th FebruaryWelcome: Sara HiomKeynote: Professor Harry De KoningEmerging evidence: a spotlight on lung cancerKeynote: Dr Jem RashbassExploring and using national cancer data for patient gain‘Zombie Apocalypse’Keynote: Sara Hiom, Cancer Research UKKeynote: Professor Robert Steele CBELate breaking showcaseKeynote: Professor Sir Mike Richards CBETargeted breast screening and care: developments and insights to shape the future for patients with breast cancer
Panel debate: accelerating innovation and advancements in researchPanellists including: Professor Gareth Evans, Fiona Walter, Geoffrey Hamilton-Fairley, Professor Stan Kaye, Fiona Reddington
Reflections from day one: Mike Richards and Sara HiomAccelerating the pace of scientific progress through access to data
CRUK funding opportunities and advice: Population research and research careers team
10 Years On: Anniversary Dinner and Awards
Wednesday 13th FebruaryKeynote: Professor Willie Hamilton CBE
Optimising recognition and referral across the patient pathway
Keynote: Cally Palmer CBE
Panel debate: Accelerating shifts in stagePanellists including Professor Tom Crosby OBE, Jane Lyons, Professor Willie Hamilton CBE, Dr Jodie Moffat, Tom Haswell
Working lunch: Spotlight on cancer pathwaysSpeakers include: Professor Tom Crosby OBE, David Fitzgerald, Margaret Kelly
Spotlight: cervical screening Emerging evidence from MDCs in the UK
Using local data to drive progress
Considering the impact of early diagnosis: recurrences and secondary cancers
FIT in symptomatic: emerging evidence and opportunities
Keynote: Mr John Butler
Evidence to make a difference in rare and less common cancers
Housekeeping
Mobile phonesFire drills Eventpro UK
Evaluation forms Presentations Filming
Wifi: BTOpenZonePassword: cruk19
Slido: Download app or sign up at www.sli.do
• Late stage diagnosis is still a problem
• Progress over the last 10 years:- Screening- Awareness & Beliefs- Primary Care- Diagnostic Pathways
Early diagnosis: 10 years on
Late stage diagnosis is still a problem
2009
2011
2015
2017
2013
2019
How can we reduce late stage diagnosis?
Act across the
pathway
Hiom et al. (2015) Diagnosing cancer earlier: reviewing the evidence for improving cancer survival. BJC
The changing focus on early diagnosis in cancer strategies
2007
2008
2011
2015
2016
2017
2019
Cancer Reform Strategy1 for England published. The first to include early diagnosis as a priority
Scotland’s Better Cancer Care Action Plan2 launchedCancer strategy for NorthernIreland (NI) published
Improving Outcomes for Cancer Strategy published in England
Achieving World Class Cancer Outcomes strategy for England3 published
Beating Cancer: Ambition and Action published in ScotlandCancer Delivery Plan for the NHS to 2020 4 published in Wales
The NHS Long Term Planfor England published
1Cancer Reform Strategy, Foreword, Gordon Brown , 2Scotland’s Better Cancer Care Action Plan, 3Achieving World Class Cancer Outcomes, 4Cancer Delivery Plan
“The Scottish Government is committed to an evidence-based approach to screening” 2
“awareness and behaviours of people who might be affected by cancer and among primary care teams; improved
screening uptake and the interface between primary and secondary care; improved access and efficiency of diagnostic
and treatment services” 4
“NHS England should mandate that GPs have direct access to key investigative tests for suspected
cancer…by the end of 2015.” 3
“Early diagnosis is vital if we are to achieve a genuinely world-class cancer service”1
• Late stage diagnosis is still a problem
• Progress over the last 10 years:- Screening- Awareness & Beliefs- Primary Care- Diagnostic Pathways
Early diagnosis: 10 years on
What progress have we made in screeningover the last decade?
2008
2011
2017
2019
Bowel screening established in Northern Ireland
Bowel scope paper shows reduction in bowel cancer incidence and mortalityNational Lung Screening Trial results published
Independent Breast Screening Review published
Bowel scope screening initiated in England
Faecal immunochemical test (FIT) rolled out in ScotlandScreening and inequalities network established in ScotlandWales launch HPV as primary cervical screening testReview of Screening Programmes in ScotlandEngland - Commitment to reduce bowel cancer screening age to 50
2010
2012
2013
2018
Spotlight: Faecal Immunochemical Test
Plans for ‘FIT’, a more sensitive bowel cancer test… will be confirmed. 1
2015
1 Achieving World Class Cancer Outcomes 2 NHSE announcement 3 GOV Wales newsroom 3 sTV News
NHSE2017
The introduction of FIT within the bowel screening programme is
expected to start during 2018/193
2017…new bowel cancer screening test
that will enhance our ability to save lives
2015
Replacement of the gFOBt test with the more sensitive and easier-to-use faecal immunochemical test (FIT) 1
Plans for ‘FIT’, a more sensitive bowel cancer test… will be confirmed2
KW37
Slide 12
KW37 https://phescreening.blog.gov.uk/2016/07/25/were-getting-fit-for-bowel-cancer-screening/ (2016 blog, flagging intro of FIT in England in Spring/Summer 2018)
NSC press release https://www.gov.uk/government/news/uk-nsc-recommendations-include-new-bowel-cancer-screening-testKathryn Whitmore, 11/02/2019
What progress have we made in awareness & beliefs over the last decade?
2008
2019
National Awareness and Early Diagnosis Initiative (NAEDI) launched
Detect Cancer Early (DCE) programme launched in ScotlandFirst all-England Be Clear On Cancer campaign
ICBP awareness and beliefs about cancer paper published
First Be Cancer Aware campaign in Northern IrelandScottish Government/CRUK “wee c” campaign
2012
2013
2015
2016
Lung cancer awareness BCOC campaign in Wales
Awareness and stage shift
What progress have we made in primary care over the last decade?
2008
2019
The CAPER studies published
CRUK Facilitator programme pilotRCGP – CRUK Partnership established
PCTs replaced by CCGs. SCNs established.Cancer Decision Support (CDS) tool pilot
NG12 update – lower threshold for referralICBP Module 3 – publication linking readiness to refer with survival
2012
2013
2015
2009
2016
2018
Scottish cancer referral guidelines review
2011
Improving Cancer Outcomes recommends GP direct access for key test
National Cancer Diagnosis Audit
Spotlight: National Cancer Diagnosis Audit
What progress have we made in diagnostic pathways over the last decade?
2008
2019
First cytosponge trial published
Accelerate, Coordinate, Evaluate (ACE) launched
British Thoracic Society Guidelines for the Investigation and Management of Pulmonary NodulesCRUK Horizon scanning and Scoping the future reports published
NICE DG30 guidance for the use of FIT in symptomatic patients publishedCompletion of ACE Wave 1National Optimal Lung Cancer Pathway (NOLCP) published
2015
Preliminary ACE MDC results publishedRapid cancer diagnostic and assessment pathways published (monitored from 2020)‘Capacity to diagnose?’ CRUK report
2014
2010
2017
2018
2016
CRUK testing times to come reports published
Spotlight on multidisciplinary diagnostic centres (MDCs)
Diagnosing cancer: a needle in a haystack
Routes to diagnosis, England, 2016
0
20
40
60
80
100
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2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
20,000
I II III IV I II III IV I II III IV I II III IV I II III IV
1-ye
ar s
urvi
val (
%)
Num
ber d
iagn
osed
per
yea
r
Incidence by stage (2016) overlaid with 1- year survival by stage (2015, followed up to 2016)
Number of cases 1yr survivalBreast Prostate Lung Bowel Melanoma
Stage:
Late stage diagnosis is still a problem
We need
Thank you!
#CRUK10yearsofearlydiagnosis
Cancer Research UK 5th Biennial Early Diagnosis Research Conference11th – 13th February 2019Birmingham, UK