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Early Diagnosis of Cancer
Working with GP Practices in
Islington
What comes into your
head when you think
about cancer?
Cancer in England
• More than 331,000 people were
diagnosed with cancer in 2011 in the UK that’s around 910 people every day
• Twice as many people survive cancer now
compared with 40 years ago.
Cancer Survival
• If England’s cancer survival
rates were the same as the
European average, 5,000
lives would be saved every
year and
• 10,000 if England was same
as best in Europe.
• Diagnosis at a late stage is
thought to be the single most
important reason for lower
survival rates in England.
Do you know what the
most common cancers
are?
Most common cancers in
Islington
The most common
cancers in Islington are
breast, lung, bowel and
prostate.
These are the four most
common cancers in UK.
Cancer in Islington
• The rate of new cancer cases (for all cancer types) and
cancer deaths is significantly higher in Islington than in
London and England.
• This is largely because Islington has higher levels of
deprivation, which is associated with:
– risk factors for cancer, such as high smoking rates, increased
alcohol consumption and higher levels of overweight and obesity,
– lower awareness of cancer symptoms and national cancer
screening programmes.
Cancer deaths in Islington
Total number of cancer deaths2010/12
Lung cancer is the biggest
cause of cancer death,
followed by bowel and
breast cancer.
Cancer is the biggest
cause of premature death
(under 75 years) in
Islington and the second
biggest cause of death
overall.
Source: ONS, 2012
Diagnosing cancer earlier saves
lives
• Do you know how many people survive
bowel cancer and breast cancer if it is
diagnosed early?
Early diagnosis of bowel cancer shows 93%
of those diagnosed survive 5 years or longer
Late diagnosis of bowel cancer where the
disease is advanced, less than 7% of
those diagnosed will survive five years or
longer
In breast cancer early diagnosis results in
92% survival rate of five years or longer
and people diagnosed with advance disease
15% surviving five years or longer.
©
How can we help to diagnose
cancer earlier?
• Raise awareness of cancer symptoms
• Encourage people to go to their GP
• Raise awareness of the importance of
screening
• Talk about cancer
So....what are the
symptoms
of cancer?
Why do
some people delay going
to the doctor with
symptoms?
Barriers to seeing a GP
Reasons for delaying presentation of symptoms to a doctor – Islington 2012
Difficult to arrange transport
Too busy to go to doctor
Doctor too difficult to talk to
Worried about wasting doctor’s time
2012
Too many other things to worry about
Too embarrassed
Difficult to make an appointment with my doctor
Too worried about what doctor might find
Too scared
0%
5%
10%
15%
20%
25%
30%
Cancer screening
The number of people taking part in the national cancer screening
programmes in Islington is lower than the London and England average
and below the national targets.
Source: NHS England, March 2013; Bowel screening, 2012/13
Myths & Beliefs
©
GP practices are important in early
diagnosis
To help improve early diagnosis:
• people need to go and see their doctor as
soon as they notice unusual or persistent
symptoms and
• doctors and patients need to have
effective consultations so that important
symptoms are discussed.
However..
• Some people do not go to their GP with symptoms early
enough.
• Some people are not aware of cancer symptoms, what
causes cancer, role of screening.
• GPs will only see 7-8 new cancer cases in a year.
• Many cancer symptoms could also be symptoms of
something else.
• GP appointments last around 10 minutes.
How
can we tackle
this?
YOU
©
What can your patient group do
to help with early diagnosis?
•Raise awareness of cancer symptoms
•Prevention messages & promoting
screening
•Encourage people to go to their GP
•Effective consultations
Raise awareness
Prevention
SMOKIN
G
Effective consultations
• GPs have limited time with patients and continuity of care is less
common nowadays - patients often have a relationship with a
practice rather than a doctor.
• Patients often wait to be prompted by the doctor before discussing
certain symptoms.
• GPs often say that patients will wait until the end of the consultation
to discuss their most serious or worrying symptoms.
• The less time a GP spends on clinical investigation means that they
are less likely to gather enough meaningful information/consider
possibility of cancer.
• This can result in GPs being less likely to spot changes in an
individual; symptoms can be attributed to existing conditions and
patients feel that they are not being listened to.
What could
you do in your practice
to make this better?
Tips for visiting your doctor
Before the appointment
• Keep a symptom diary
– write down what’s been happening, how long it’s been
going on for, and how often it occurs.
– Make sure you include everything even if you think it’s
not serious or related (like if you’ve been feeling more
tired or have lost weight).
• Take a notebook
– Write down what you want to say
– Make a list of questions/problems you want to discuss
before the appointment.
Tips for visiting your doctor
At the practice
• Provide a ‘consultation’ sheet for patients to fill in while
waiting to see the GP. This could include things like:
– What you want to talk to the doctor about
– How long you have had symptoms
During the consultation
• Be direct. If you have a problem that you find
embarrassing or difficult to talk about, don’t leave it to
the end of the appointment before mentioning it.
Remember your problem is likely to be a common one
for your GP, who is there to help you.
• Don’t be afraid to say if you don’t understand something
your doctor has said.
We are happy to help if you want to discuss anything
further.
There is a pack for each practice with leaflets and
posters.
Thank you for inviting us to your meeting.
Contact details:
Anne-Marie Love
Gwen Kaplan
Senior Primary Care Facilitator
for Cancer – Islington
Email: [email protected]
Cancer Awareness Lead Trainer
Cancer Research UK
[email protected]
Mobile: 07918721709