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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 • Cancer survival rates in the UK have doubled in the last 40 years. Cancer in England • 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. Cancer in Islington 3,221 people living in Islington have had a diagnosis of cancer.2012 711 people are diagnosed with cancer in Islington each year (2010-2012 average). Higher rate of new cancer cases in Islington compared to other London boroughs and to the England average 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 deaths in Islington Total number of cancer deaths2010/12 316 deaths each year from cancer in Islington.2010-2012 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. 167 early deaths (aged under 75 years) each year from cancer in Islington.2010-2012 Source: ONS, 2012 In summary.... • 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. • Diagnosis of cancer at a late stage is thought to be the single most important reason for lower survival rates in England. 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. © 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. So what can we do? • 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? 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 © 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 - 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