Cancer in the United Kingdom

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The passing of the Cancer Act 1939 marked the political significance of cancer treatment. It envisaged a system of co-ordination of diagnosis and treatment under the control of County Councils and County Borough Councils which preceded the establishment of the National Health Service (NHS). The outbreak of war prevented most of its provisions from coming into effect. [1]

Contents

Types of cancer

Breast cancer

Breast cancer is the most common cancer in the UK (around 56,000 women and 375 men are diagnosed with the disease every year). It is the fourth most common cause of cancer death (around 11,400 women and 85 men die each year) and the second most common cause of death in women. [2] As age and biological sex are the biggest risk factors, women over 50 are automatically invited to participate in the NHS Breast Screening Programme every three years. [3] The screening programme was shown to reduce the number of deaths from breast cancer and produce only a modest number of overdiagnosis. [4] [5]

Performance

There were 361,216 cancer diagnoses in 2014 in the United Kingdom. [6] Cancer Research UK publishes detailed statistics of the incidence of and mortality from cancer in the UK. [7] Cancer Research UK estimates that 15% of UK cancers are caused by smoking, [8] and 3-4% of UK cancers are related to alcohol consumption. [9] Treatment of cancer has been a recurring issue in the National Health Service. Official guidelines state that no one in England should have to wait more than 62 days for cancer treatment after a referral from their general practitioner. However, press reports in 2015 indicated that some patients had to wait longer. [10] [11] On 4 September 2015, the NHS announced it would no longer pay for 17 different cancer medications. The Telegraph reported that over 5,000 patients with breast, bowel, skin, and pancreatic cancers would be affected. [12]

A five-year Cancer Strategy Implementation Plan was published by NHS England in 2015. It promises considerable investment in linear accelerators There have been some improvements in cancer care but too many patients are waiting too long for diagnosis and treatment. Sir Harpal Kumar criticised the government's child obesity strategy. He said the report was not tough enough on the food industry, given the number of cancers which are linked to lifestyle. The increased investment does not appear to be sufficient to meet the rise in the number of cancer patients, and there are shortages of radiologists, specialist nurses and other key staff. [13]

Targets

National cancer waiting times standards were established by NHS England in 2009 (and the same targets have been set by NHS Scotland). In 2017 the targets are

The targets are monitored monthly and in the period from 2014 to 2016 were only met in 4 months out of 36. [15]

Sara Hiom of Cancer Research UK said, ‘The state of NHS diagnostic services is deeply concerning – and new GP referral guidelines from NICE mean that even more patients will be waiting for these tests. There aren’t enough trained staff, they're often reliant on outdated equipment and in many cases they're already operating services seven days a week.' Dr Giles Maskell of the Royal College of Radiologists said, ‘Well-resourced testing services are crucial to the early diagnosis of cancer, which in turn is vital to increase survival from the disease.' Cancer Research UK is calling on the government to provide funding for earlier diagnosis of cancer as prompt diagnosis increases the chances the patient will survive. [16]

See also

Related Research Articles

<span class="mw-page-title-main">Breast cancer</span> Cancer that originates in mammary glands

Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, milk rejection, fluid coming from the nipple, a newly inverted nipple, or a red or scaly patch of skin. In those with distant spread of the disease, there may be bone pain, swollen lymph nodes, shortness of breath, or yellow skin.

<span class="mw-page-title-main">Cancer</span> Group of diseases involving abnormal cell growth and spread

Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal bleeding, prolonged cough, unexplained weight loss, and a change in bowel movements. While these symptoms may indicate cancer, they can also have other causes. Over 100 types of cancers affect humans.

<span class="mw-page-title-main">Mammography</span> Process of using low-energy X-rays to examine the human breast for diagnosis and screening

Mammography is the process of using low-energy X-rays to examine the human breast for diagnosis and screening. The goal of mammography is the early detection of breast cancer, typically through detection of characteristic masses or microcalcifications.

<span class="mw-page-title-main">The Brain Tumour Charity</span> British charity founded in 1996

The Brain Tumour Charity is a UK-based, Charity Commission registered, charity dedicated to funding research, raising awareness of brain tumours, reducing diagnosis times and providing support and information for people with brain tumours, their families and friends.

<span class="mw-page-title-main">Screening (medicine)</span> Brief medical evaluation to detect unnoticed health problems

Screening, in medicine, is a strategy used to look for as-yet-unrecognised conditions or risk markers. This testing can be applied to individuals or to a whole population. The people tested may not exhibit any signs or symptoms of a disease, or they might exhibit only one or two symptoms, which by themselves do not indicate a definitive diagnosis.

Overdiagnosis is the diagnosis of disease that will never cause symptoms or death during a patient's ordinarily expected lifetime and thus presents no practical threat regardless of being pathologic. Overdiagnosis is a side effect of screening for early forms of disease. Although screening saves lives in some cases, in others it may turn people into patients unnecessarily and may lead to treatments that do no good and perhaps do harm. Given the tremendous variability that is normal in biology, it is inherent that the more one screens, the more incidental findings will generally be found. For a large percentage of them, the most appropriate medical response is to recognize them as something that does not require intervention; but determining which action a particular finding warrants can be very difficult, whether because the differential diagnosis is uncertain or because the risk ratio is uncertain.

<span class="mw-page-title-main">NHS Scotland</span> Publicly-funded healthcare system in Scotland

NHS Scotland, sometimes styled NHSScotland, is the publicly funded healthcare system in Scotland and one of the four systems that make up the National Health Service in the United Kingdom. It operates 14 territorial NHS boards across Scotland, supported by seven special non-geographic health boards, and Public Health Scotland.

Health and Social Care (HSC) is the publicly funded healthcare system in Northern Ireland. Although having been created separately to the National Health Service (NHS), it is nonetheless considered a part of the overall national health service in the United Kingdom. The Northern Ireland Executive through its Department of Health is responsible for its funding, while the Public Health Agency is the executive agency responsible for the provision of public health and social care services across Northern Ireland. It is free of charge to all citizens of Northern Ireland and the rest of the United Kingdom.

<span class="mw-page-title-main">Breast cancer screening</span> Medical screening of asymptomatic, healthy women for breast cancer

Breast cancer screening is the medical screening of asymptomatic, apparently healthy women for breast cancer in an attempt to achieve an earlier diagnosis. The assumption is that early detection will improve outcomes. A number of screening tests have been employed, including clinical and self breast exams, mammography, genetic screening, ultrasound, and magnetic resonance imaging.

<span class="mw-page-title-main">Breakthrough Breast Cancer</span>

Breakthrough Breast Cancer was a United Kingdom charity whose mission was to "save lives through improving early diagnosis, developing new treatments and preventing all types of breast cancer". In 2015, Breakthrough Breast Cancer merged with another UK charity, Breast Cancer Campaign, to form the UK's largest breast cancer research charity - Breast Cancer Now. In 2019, Breast Cancer Care merged with Breast Cancer Now and the two organizations together became known as Breast Cancer Now.

Health in the United Kingdom refers to the overall health of the population of the United Kingdom. This includes overall trends such as life expectancy and mortality rates, mental health of the population and the suicide rate, smoking rates, alcohol consumption, prevalence of diseases within the population and obesity in the United Kingdom. Three of these, smoking rates, alcohol consumption and obesity are above the OECD average.

<span class="mw-page-title-main">National Health Service</span> Publicly-funded healthcare systems in the United Kingdom

The National Health Service (NHS) is the conglomerate name for the publicly funded healthcare systems of the United Kingdom, comprising NHS England, NHS Scotland and NHS Wales. Health and Social Care in Northern Ireland was created separately and is often locally referred to as "the NHS". The original three systems were established in 1948 as part of major social reforms following the Second World War. The founding principles were that services should be comprehensive, universal and free at the point of delivery—a health service based on clinical need, not ability to pay. Each service provides a comprehensive range of health services, provided without charge for people ordinarily resident in the United Kingdom apart from dental treatment and optical care. In England, NHS patients have to pay prescription charges; some, such as those aged over 60, or those on certain state benefits, are exempt.

NHS targets are performance measures used by NHS England, NHS Scotland, NHS Wales, and the Health and Social Care service in Northern Ireland. These vary by country but assess the performance of each health service against measures such as 5 hour waiting times in Accident and Emergency departments, weeks to receive an appointment and/or treatment, and performance in specific departments such as oncology.

<span class="mw-page-title-main">Epidemiology of cancer</span> The study of factors in cancer causes and treatments

The epidemiology of cancer is the study of the factors affecting cancer, as a way to infer possible trends and causes. The study of cancer epidemiology uses epidemiological methods to find the cause of cancer and to identify and develop improved treatments.

The National Cancer Intelligence Network (NCIN), was set up in 2008 to drive improvements in care standards and clinical outcomes. NCIN is now part of Public Health England, following the Health and Social Care Act 2012.

<span class="mw-page-title-main">Cancer screening</span> Method to detect cancer

Cancer screening aims to detect cancer before symptoms appear. This may involve blood tests, urine tests, DNA tests, other tests, or medical imaging. The benefits of screening in terms of cancer prevention, early detection and subsequent treatment must be weighed against any harms.

<span class="mw-page-title-main">Epidemiology of breast cancer</span>

Worldwide, breast cancer is the most common invasive cancer in women. Breast cancer comprises 22.9% of invasive cancers in women and 16% of all female cancers.

Brighton and Sussex University Hospitals NHS Trust (Now disbanded), abbreviated as BSUH, was an NHS foundation trust ran two acute hospitals, the Royal Sussex County Hospital in Brighton and the Princess Royal Hospital in Haywards Heath. It also operated a number of other hospitals and medical facilities, including the Royal Alexandra Children's and Sussex Eye Hospitals in Brighton, Hove Polyclinic, the Park Centre for Breast Care at Preston Park and Hurstwood Park Neurosciences Centre in Haywards Heath. The Trust also provided services in Brighton General Hospital, Lewes Victoria Hospital, Bexhill Renal Satellite Unit, Eastbourne District General Hospital and Worthing Hospital.

Jill Wruble is a radiologist and fellow at Johns Hopkins Medicine who is best known as a speaker on overdiagnosis due to incidental imaging finding in United States medicine.

Fiona Jane Gilbert is a Scottish radiologist and academic.

References

  1. ↑ Webster, Charles (1988). The Health Services Since the War. London: HMSO. p. 8. ISBN   0116309423.
  2. ↑ "Facts and figures". Breast Cancer UK. Retrieved 2023-10-20.
  3. ↑ Why we need to understand breast cancer risk (Report). National Institute for Health and Care Research. 2023-10-05. doi:10.3310/nihrevidence_60242.
  4. ↑ Maroni, Roberta; Massat, Nathalie J.; Parmar, Dharmishta; Dibden, Amanda; Cuzick, Jack; Sasieni, Peter D.; Duffy, Stephen W. (2021-02-16). "A case-control study to evaluate the impact of the breast screening programme on mortality in England". British Journal of Cancer. 124 (4): 736–743. doi:10.1038/s41416-020-01163-2. ISSN   0007-0920. PMC   7884709 . PMID   33223536.
  5. ↑ "Benefits of NHS Breast Screening Programme outweigh the small risk of overdiagnosis". Queen Mary University of London. 2022-07-19. Retrieved 2023-10-23.
  6. ↑ "Cancer Is More Common Than Marriage Or Having A First Baby In The UK". International Business Times. 10 July 2017. Retrieved 10 July 2017.
  7. ↑ "Cancer Statistics for the UK". Cancer Research UK. Retrieved 10 July 2017.
  8. ↑ "Cancer risk statistics, subheading Tobacco statistics". Cancer Research UK. Retrieved 18 August 2022.
  9. ↑ "Cancer risk statistics, subheading Preventable cancers". Cancer Research UK. Retrieved 18 August 2022.
  10. ↑ "NHS failing cancer patients with life-threatening delays" . Retrieved 5 September 2015.
  11. ↑ "More NHS hospitals breach waiting times for cancer treatment" . Retrieved 5 September 2015.
  12. ↑ "Thousands of cancer patients to be denied treatment" . Retrieved 5 September 2015.
  13. ↑ Triggle, Nick (25 October 2016). "Cancer care: Is world class status a distant dream?" – via www.bbc.co.uk.
  14. ↑ "Waiting times for tests and treatment after cancer diagnosis". Cancer research UK. Retrieved 10 March 2017.
  15. ↑ "NHS misses cancer wait time targets for nearly three years". Healthcare Leader. 13 January 2017. Archived from the original on 12 March 2017. Retrieved 10 March 2017.
  16. ↑ NHS cancer services ‘underfunded and understaffed’
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