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Download NHS Forth Valley Palliative Care Strategy 2006
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Men’s Health and Cancer 4th December 2009 Dr Paul Baughan GP, Dollar Health Centre, Clackmannanshire Clinical Lead, WoSCAN Primary Care Group Men’s health and cancer 1. Cancer in Scotland today 2. Role of West of Scotland Cancer Network (WoSCAN) 3. Specific projects relating to Men’s Health and cancer within WoSCAN Lifetime risk of cancer in Scotland 1 in 3 men in Scotland will develop some form of cancer during their lifetime. For males, the lifetime risk of developing: - lung cancer is estimated as 1 in 13 - prostate cancer is 1 in 13 - colorectal cancer is 1 in 18 men Figure 1: Ten most commonly diagnosed cancers in males, 2006 Other 20.4% Trachea, bronchus and lung 19.2% Kidney 3.2% Non-Hodgkin's lymphoma 3.3% Malignant melanoma of skin 3.4% Prostate 19.2% Bladder 3.6% Stomach 3.7% Oesophagus 4.0% Head and Neck 5.8% Colorectal 14.1% Figure 5:Scotland: Number of registrations age-specific rates per 100,000, malignant neoplasm's diagnosed in 2006, by Numberand of new cancers and rate all per 100 000 by gender in 2006 sex 2,500 4,000 3,500 2,000 3,000 Males: numbers Females: numbers 2,500 Females: rates 2,000 1,000 1,500 1,000 500 500 0 0 Under 5 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Age at diagnosis 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Rate per 100, 000 Number of registrations Males: rates 1,500 Survival from cancer in Scotland Survival is worst in patients with cancers that often present at an advanced stage and are less amenable to treatment (for example, cancers of the lung and pancreas). Survival tends to be better for: - cancers for which patients present at an early stage (for example, malignant melanoma of the skin), - cancers which can be detected early by screening (for example, breast cancer) - cancers for which there have been major advances in treatment (for example, testicular cancer and leukaemias). Survival from cancer in Scotland 5 Year Survival Rate by Gender 60 51 50 42 % Survival 40 38 Men 30 Women 26 20 10 0 1984 2004 Year Prevalence of cancer Over all ages, 2.2% of men in Scotland are living with cancer The prevalence of cancer in the Scottish population increases with age, with 10% of men aged 65 and over living with cancer Cancer in men in Scotland • Incidence is higher • Survival rates are lower • Prevalence is higher Men’s health and cancer 1. Cancer in Scotland today 2. Role of West of Scotland Cancer Network (WoSCAN) 3. Specific projects relating to Men’s Health and cancer within WoSCAN What is a network? ‘An extended group of people with similar interests or concerns who interact and remain in informal contact for mutual assistance or support’ What is a managed clinical network? "linked groups of health professionals and organisations from primary, secondary and tertiary care, working in a coordinated manner, unconstrained by existing professional and Health Board boundaries, to ensure equitable provision of high quality clinically effective services throughout Scotland". West of Scotland Cancer Network (WoSCAN) Organisational Char t, West of Scotland Can ce r Ne twork NHS QIS NHS Areas , Loc al Canc er & Palliativ e Care Groups / Networks Royal College s Regional Managed Clinic al Networks Centre for Chang e & Innovation National Managed Clinic al Networks Formalis ed Regional Networks Breas t Ay rs hire & Arran Forth Valley Greater Glas gow & Cly de Colorec tal Hepatobiliary MCN Gy naecology Sk in Lung Lanarks hire Nurs ing Pharmac y Bone & Soft Tis s ue Sarc oma MCN Neuro oncology Primary Care Pres c ribing Adv is ory Group Cepas Projec t Board Head & Nec k Wes t of Sc otland Population Patient Partners hip Forum Waiting Times Upper GI Haematoonc ology Chemotherapy Strategic Rev iew Implementation Group Spec ialis t Onc ology Strategic Rev iew Group Urology SIGN Sub- Groups SCRN Palliativ e Care Dumfries & Galloway Wes tern Is les ( Uis t) SEHD Regional Canc er Clinic al Leads Group National Serv ic es Regional Planning Group RCAG Sc ottis h Canc er Tas k force Regional Serv ic es Paediatric s BMT Genetic s Opthalmic Sc reening West of Scotland C ance r Ne twork Loc al Authorities Univ ers ities Voluntary Organis ations West of Scotland Cancer Network Organisational Char t, West of Scotland Can ce r Ne twork NHS QIS NHS Areas , Loc al Canc er & Palliativ e Care Groups / Networks Royal College s Regional Managed Clinic al Networks Centre for Chang e & Innovation National Managed Clinic al Networks Formalis ed Regional Networks Breas t Ay rs hire & Arran Forth Valley Greater Glas gow & Cly de Colorec tal Hepatobiliary MCN Gy naecology Sk in Lung Lanarks hire Nurs ing Pharmac y Bone & Soft Tis s ue Sarc oma MCN Neuro oncology Primary Care Pres c ribing Adv is ory Group Cepas Projec t Board Head & Nec k Wes t of Sc otland Population Patient Partners hip Forum Waiting Times Upper GI Haematoonc ology Chemotherapy Strategic Rev iew Implementation Group Spec ialis t Onc ology Strategic Rev iew Group Urology SIGN Sub- Groups SCRN Palliativ e Care Dumfries & Galloway Wes tern Is les ( Uis t) SEHD Regional Canc er Clinic al Leads Group National Serv ic es Regional Planning Group RCAG Sc ottis h Canc er Tas k force Regional Serv ic es Paediatric s BMT Genetic s Opthalmic Sc reening West of Scotland C ance r Ne twork Loc al Authorities Univ ers ities Voluntary Organis ations West of Scotland Cancer Network Organisational Char t, West of Scotland Can ce r Ne twork NHS QIS NHS Areas , Loc al Canc er & Palliativ e Care Groups / Networks Royal College s Regional Managed Clinic al Networks Centre for Chang e & Innovation National Managed Clinic al Networks Formalis ed Regional Networks Breas t Ay rs hire & Arran Forth Valley Greater Glas gow & Cly de Colorec tal Hepatobiliary MCN Gy naecology Sk in Lung Lanarks hire Nurs ing Pharmac y Bone & Soft Tis s ue Sarc oma MCN Neuro oncology Primary Care Pres c ribing Adv is ory Group Cepas Projec t Board Head & Nec k Wes t of Sc otland Population Patient Partners hip Forum Waiting Times Upper GI Haematoonc ology Chemotherapy Strategic Rev iew Implementation Group Spec ialis t Onc ology Strategic Rev iew Group Urology SIGN Sub- Groups SCRN Palliativ e Care Dumfries & Galloway Wes tern Is les ( Uis t) SEHD Regional Canc er Clinic al Leads Group National Serv ic es Regional Planning Group RCAG Sc ottis h Canc er Tas k force Regional Serv ic es Paediatric s BMT Genetic s Opthalmic Sc reening West of Scotland C ance r Ne twork Loc al Authorities Univ ers ities Voluntary Organis ations West of Scotland Cancer Network Organisational Char t, West of Scotland Can ce r Ne twork NHS QIS NHS Areas , Loc al Canc er & Palliativ e Care Groups / Networks Royal College s Regional Managed Clinic al Networks Centre for Chang e & Innovation National Managed Clinic al Networks Formalis ed Regional Networks Breas t Ay rs hire & Arran Forth Valley Greater Glas gow & Cly de Colorec tal Hepatobiliary MCN Gy naecology Sk in Lung Lanarks hire Nurs ing Pharmac y Bone & Soft Tis s ue Sarc oma MCN Neuro oncology Primary Care Pres c ribing Adv is ory Group Cepas Projec t Board Head & Nec k Wes t of Sc otland Population Patient Partners hip Forum Waiting Times Upper GI Haematoonc ology Chemotherapy Strategic Rev iew Implementation Group Spec ialis t Onc ology Strategic Rev iew Group Urology SIGN Sub- Groups SCRN Palliativ e Care Dumfries & Galloway Wes tern Is les ( Uis t) SEHD Regional Canc er Clinic al Leads Group National Serv ic es Regional Planning Group RCAG Sc ottis h Canc er Tas k force Regional Serv ic es Paediatric s BMT Genetic s Opthalmic Sc reening West of Scotland C ance r Ne twork Loc al Authorities Univ ers ities Voluntary Organis ations West of Scotland Cancer Network Organisational Char t, West of Scotland Can ce r Ne twork NHS QIS NHS Areas , Loc al Canc er & Palliativ e Care Groups / Networks Royal College s Regional Managed Clinic al Networks Centre for Chang e & Innovation National Managed Clinic al Networks Formalis ed Regional Networks Breas t Ay rs hire & Arran Forth Valley Greater Glas gow & Cly de Colorec tal Hepatobiliary MCN Gy naecology Sk in Lung Lanarks hire Nurs ing Pharmac y Bone & Soft Tis s ue Sarc oma MCN Neuro oncology Primary Care Pres c ribing Adv is ory Group Cepas Projec t Board Head & Nec k Wes t of Sc otland Population Patient Partners hip Forum Waiting Times Upper GI Haematoonc ology Chemotherapy Strategic Rev iew Implementation Group Spec ialis t Onc ology Strategic Rev iew Group Urology SIGN Sub- Groups SCRN Palliativ e Care Dumfries & Galloway Wes tern Is les ( Uis t) SEHD Regional Canc er Clinic al Leads Group National Serv ic es Regional Planning Group RCAG Sc ottis h Canc er Tas k force Regional Serv ic es Paediatric s BMT Genetic s Opthalmic Sc reening West of Scotland C ance r Ne twork Loc al Authorities Univ ers ities Voluntary Organis ations Men’s health and cancer 1. Cancer in Scotland today 2. Role of West of Scotland Cancer Network (WoSCAN) 3. Specific projects relating to Men’s Health and cancer within WoSCAN Specific projects relating to Men’s Health and cancer within WoSCAN 1. 2. 3. 4. Bowel screening Early presentation of men with cancer Referral to secondary care Complications of cancer Bowel Screening programme - Women AND MEN aged 50-74 - Started Ayrshire and Arran Sept 07 - Greater Glasgow and Clyde April 09 Bowel Screening programme Colorectal screening uptake in Clackmannanshire 08-09 Uptake in colorectal screening programme 2008-09 70 60 % uptake 50 Men 40 Women 30 20 10 0 Falkirk Stirling Clackmannanshire Number invited: 12 682 women, 11 905 men - Gathering opinion and experiences from general population about bowel screening programme, including the helpfulness of patient literature and ways to improve uptake. Specific projects relating to Men’s Health and cancer within WoSCAN 1. 2. 3. 4. Bowel screening Early presentation of men with cancer Referral to secondary care Complications of cancer The ‘Patient Pathway?’ <62 days for 95% of urgent referrals Urgent GP Referral Assessment And Diagnosis MDT meeting Commence Treatment Patient notices symptoms The real ‘Patient Pathway’ Patient reports symptoms ? GP decides to refer <62 days for 95% of urgent referrals Urgent GP Referral Assessment And Diagnosis MDT meeting Commence Treatment Early diagnosis audit of cancer • • • GPs asked to review notes of every patient diagnosed with cancer during 2007 Note when patient initially spotted symptoms, when they first reported them to GP or nurse and when they were referred to secondary care Comment on ways to improve the pathway Distribution of tumour type 2000 1500 1000 500 0 Unknown Primary Upper GI 81% GP practices took part. 10 286 cancers identified Prostate Tumour group Ovarian Other urological Other Melanoma Lymphoma Lung Leukaemia Head & Neck Colorectal Cervical Breast Bladder number of tumours diagnosed All Participating Boards Time from symptoms to presentation Median time from symptoms to first presentation by diagnosis and inter-quartile range All Participating boards Bladder Breast Cervical Colorectal Head & Neck Diagnosis Leukaemia Median time Lung Lymphoma Melanoma Other Other urological Ovarian Prostate UGI Unknow n Primary 0 10 20 30 40 50 60 Median time (days) 70 80 90 100 Time from presentation to referral Median time from first presentation to referral by diagnosis and inter-quartile range All participating boards Bladder Breast Cervical Colorectal Head & Neck Leukaemia Diagnosis Median time Lung Lymphoma Melanoma Other Other urological Ovarian Prostate UGI Unknow n Primary 0 5 10 15 Median time (days) 20 25 Gender differences Median time from symptoms to first presentation - by gender and diagnosis Bladder Male Female Diagnosis Colorectal Lung Melanoma Upper GI 0 10 20 30 40 50 60 Median time (days) 70 80 90 100 Median time from first presentation to referral - by diagnosis group and gender Bladder Female Male Diagnosis Colorectal Lung Melanoma Upper GI 0 5 10 15 20 Median time (days) 25 30 35 Specific projects relating to Men’s Health and cancer within WoSCAN 1. 2. 3. 4. Bowel screening Early presentation of men with cancer Referral to secondary care Complications of cancer Examined all ‘Urgent suspected cancer’ referrals by GPs over a six month period across West of Scotland Numbers of urgent referrals per 1000 population: n = 1400 n = 2074 n = 5692 n = 2537 n = 11703 Number of urgent referrals per 1000 population by tumour type: Proportion of urgent referrals where same cancer diagnosed as suspected: n = 1400 n = 2074 n = 5692 n = 2537 n = 11703 Proportion of urgent referrals where same cancer diagnosed by tumour type: Proportion of urgent referrals where urgent referral complied with guidelines by tumour type: Specific projects relating to Men’s Health and cancer within WoSCAN 1. 2. 3. 4. Bowel screening Early presentation of men with cancer Referral to secondary care Complications of cancer Safe management of cancer complications and emergencies Summary • Cancer in Scotland is important • Men have poorer outcomes with cancer • WoSCAN working on number of initiatives to understand and improve care that men with cancer receive How do we engage with men better? [email protected]
