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Found 166 results
  1. Content Article
    Cancer screening involves testing for early signs of cancer in people without symptoms. It can help spot cancers at an early stage, when treatment is more likely to be successful, or in some cases prevent cancer from developing the first place. The screening test for bowel cancer is the faecal immunochemical test, or FIT, that looks for tiny traces of blood in your poo. These tests are sent to everyone in the eligible population every two years. In this blog Jacob Smith from Cancer Research UK looks at the importance of increasing bowel cancer screening in socioeconomically deprived communities, where there is a higher incidence of bowel cancer and death from bowel cancer. This is partly due to lower levels of participation in screening. The blog highlights the results of a recent study carried out by the University of Sheffield to determine which interventions may be successful in reducing health inequalities related to bowel cancer screening. Modelling found that re-inviting non-participants to take part in screening each year was a highly effective intervention, and it is estimated that this approach would prevent over 11,000 bowel cancer deaths over the lifetime of the current English population aged 50-74.
  2. Content Article
    This article in The BMJ examines the risks and benefits of current prostate cancer screening methods in the UK. It highlights issues that prevent early diagnosis including great variation in how prostate cancers behave and the poor performance of prostate specific antigen (PSA) testing in identifying disease that requires treatment. As a result of the limited benefits of screening for prostate cancer, routine screening is not recommended by the UK’s National Screening Committee or the US Preventive Service Task Force. The authors highlight that a bid by NHS England to find an estimated 14,000 men who have not yet started treatment for prostate cancer due to the pandemic, seems to contradict this recommendation. The NHS campaign warns that people shouldn’t wait for symptoms and encourages men to use a risk checker which informs patients of risk factors including family history, age and ethnicity. The authors express concern that the campaign implies there is great benefit in detecting asymptomatic disease, which could lead people to believe that the NHS is promoting screening. They argue that the NHS needs to be clearer and more consistent in its messaging, making sure that information aimed at the public emphasises that although PSA testing is available on request for men older than 50, it is not currently recommended, and why.
  3. Content Article
    This retrospective cohort study in the British Journal of General Practice aimed to identify opportunities for timely investigations or referrals in patients presenting with potential symptoms of colon and rectal cancer, or abnormal blood tests. The study found evidence that patients with these cancers presented with low haemoglobin, high platelets and high inflammatory markers as early as nine months pre-diagnosis, and the authors suggest that starting cancer-specific investigations or referrals earlier may be beneficial in patients with some of these diagnostic markers.
  4. News Article
    People with a worrying cough, problems swallowing or blood in their urine will soon be able to be referred for scans and checks by a pharmacist, rather than having to wait to see their GP. The new pilot scheme, in England, aims to diagnose more cancers early, when there is a better chance of a cure. High Street pharmacies will be funded to refer customers for the checks. The NHS will also send out more "roaming trucks" to perform on-the-spot scans in the community. Lung-scanner vans driven to locations, including supermarket car parks and football stadiums, have already resulted in more people having checks. Now, some liver lorries will join them. Health and Social Care Secretary Sajid Javid said: "Ensuring patients can access diagnosis and treatment easily in their communities and on High Streets is a fundamental part of our 10-Year Cancer Plan." Dr Anthony Cunliffe, national clinical adviser for primary care, at Macmillan Cancer Support, said: "Doctors and nurses are working tirelessly to diagnose and treat the tens of thousands of people entering a very busy cancer care system. "This pilot will give people the opportunity to access more trained professionals in their community to get symptoms investigated." Read full story Source: BBC News, 15 June 2022
  5. News Article
    When Jenny* had a mastectomy after being diagnosed with breast cancer, she believed the major surgery to remove her breast, although traumatic, had saved her life. She described feeling “rage” when at a follow-up appointment three years later, she said to her surgeon, “I would probably be dead by now” if she had not received the surgery, to which he replied: “Probably not.” It was only then, after she had already undergone invasive and life-changing treatment, that Jenny learned about “overdiagnosis”. While breast cancer screening programs are essential and save lives, sometimes they also detect lumps that may never go on to cause harm in a woman’s lifetime, leading to overtreatment, and psychological and financial suffering. Jenny is 1 of 12 women from the UK, US, Canada and Australia whose stories were published in the medical journal BMJ Open. It is the first study to interview breast cancer patients who believe they may have received unnecessary and harmful treatment, highlighting the effect this has had on their lives. “The usual story of breast cancer screening is ‘screening saves lives’,” an author of the study and a professor of public health at the University of Sydney in Australia, Alexandra Barratt, said. “This study reports the other side of the story – how breast cancer screening can cause harm through overdiagnosis and overtreatment.” Read full story Source: The Guardian, 8 June 2022
  6. Content Article
    This study from Pickles et al. explores experiences of women who identified themselves as having a possible breast cancer overdiagnosis.
  7. News Article
    One million checks for cancer, heart and lung disease have been carried out at new diagnostic clinics in football stadiums and shopping centres, the NHS has reported. In the past year, 92 “one-stop shop” centres offering scans, x-rays and blood tests have been opened in an effort to tackle the Covid care backlog after NHS waiting lists in England soared to a record 6.4 million patients. The NHS said it will open a further 70 centres, which will operate seven days a week and allow patients to get symptoms checked “on their doorstep” following GP referrals. The centres are staffed by nurses and radiographers who can carry out a range of diagnostic tests, including cancer scans. This means patients can get multiple tests in one visit, rather than having to make several different trips to a hospital. Professor Charles Swanton, chief clinician at Cancer Research UK, said the rapid diagnostic clinics were improving access to lifesaving treatment. Speaking at the world’s largest cancer conference in Chicago, he said: “Individuals with red-flag cancer symptoms — blood in the stool, persistent cough — can bypass the bureaucratic and lengthy standard approaches to getting investigated in hospital.” However, Swanton warned that without action to address the “chronic shortage” of 110,000 NHS staff, the new centres risked “robbing Peter to pay Paul” by taking doctors and nurses away from hospitals. Read full story (paywalled) Source: The Times, 6 June 2022
  8. News Article
    Black people are more than a third less likely than white people to be diagnosed with cancer via screening in England, according to the first study of its kind, prompting calls for targeted efforts to improve their levels of uptake. Screening programmes save lives by preventing cancer from occurring or spotting it earlier, when treatment is more likely to be effective. In England, screening for cervical cancer is offered to women aged 25 to 64, breast cancer screening is offered to women aged 50 to 70, and everyone aged 60 to 74 is offered a bowel cancer screening home test kit every two years. The latest research, however, lays bare stark disparities in screening diagnosis rates between different ethnic groups for the first time. The study of more than 240,000 cancer patients over a decade found that 8.61% of patients were diagnosed via screening. Broken down by ethnicity, the figure for white people was 8.27%, almost exactly the same as the national average, but among black people it was 5.11%. The findings suggests that black people are 38% less likely to be diagnosed via screening than white people. Diagnosis via screening in mixed-race patients was much higher at 9.49%, and higher still in Asian patients at 10.09%, almost double the rate for black patients. The results were published in the British Journal of Cancer. Jabeer Butt, the chief executive of the Race Equality Foundation, said the findings should prompt urgent action. “Cancer screening saves lives,” he said. “That’s why it is so important that effective outreach and culturally appropriate interventions are prioritised to reduce health inequalities. “We know that awareness of cancer symptoms is lower among minority ethnic groups, particularly black Africans, with higher reported barriers to seeking help. But we also know from previous research on colorectal cancer interventions that speaking to someone who explains the steps of the screening process ahead of time can lead to improvements in screening uptake in minority patients." Read full story Source: The Guardian, 6 June 2022
  9. Content Article
    UK Asian and Black ethnic groups have poorer outcomes for some cancers and are less likely to report a positive care experience than their White counterparts it was found in a study from Martins et al. reported in the British Journal of Cancer. The study investigated ethnic differences in the route to diagnosis (RTD) to identify areas in patients' cancer journeys where inequalities lie and targeted intervention might have optimum impact. Across the 10 cancers studied, most patients were diagnosed via the two-week wait (36.4%), elective GP referral (23.2%), emergency (18.2%), hospital routes (10.3%), and screening (8.61%). Patients of Other ethnic group had the highest proportion of diagnosis via the emergency route, followed by White patients. Asian and Black group were more likely to be GP-referred, with the Black and Mixed groups also more likely to follow the two-week wait route. However, there were notable cancer-specific differences in the RTD by ethnicity. These findings suggest that, where inequalities exist, the adverse cancer outcomes among Asian and Black patients are unlikely to be arising solely from a poorer diagnostic process.
  10. News Article
    Women could be screened for cervical cancer every five years instead of every three and as many cancers could still be prevented, a new study suggests. Researchers at King’s College London said that screening women aged 24 to 49 who test negative for human papillomavirus (HPV) at five-year intervals prevented as many cancers as screening every three years. The study of 1.3 million women in England, published in the BMJ, found that women in this age group were less likely to develop clinically relevant cervical lesions, abnormal changes of the cells that line the cervix known as CIN3+, and cervical cancer three years after a negative HPV screen compared to a negative smear test. Lead author Dr Matejka Rebolj, senior epidemiologist at King’s College London, said the results were “very reassuring”. She added: “They build on previous research that shows that following the introduction of HPV testing for cervical screening, a five-year interval is at least as safe as the previous three-year interval. “Changing to five-yearly screening will mean we can prevent just as many cancers as before, while allowing for fewer screens.” Read full story Source: The Independent, 31 May 2022
  11. News Article
    NHS Scotland is to change the way women are called to breast cancer detection appointments after major recent errors in the screening programme. Some eligible for screening were not invited because they had moved between GP practices or were aged over 71 by the time their practice was called. Women aged 50 to 70 are invited for appointments once every three years, based on their GP practice. It emerged hundreds of women in NHS Lothian may have missed screenings. The health board said in January that 369 women considered to have a higher risk of developing the disease may not have received appointments at the right time. A major review of the programme in Scotland has made 17 recommendations to strengthen and improve services. They include: A more "person-centred" approach based on calling individual women - rather than the GP practice where they are registered - to set their next test date. Greater flexibility of appointments to provide better access and uptake, with more contact such as texts or phone calls to keep appointments on patients' radar. An online appointment cancellation and rebooking system to provide greater individual convenience. Evening and weekend appointments and more availability in rural and semi-urban locations. Read full story Source: BBC News, 24 May 2022
  12. News Article
    A record 2.7 million people were referred for cancer checks in the last year, NHS England has said. It comes after figures suggested the Covid pandemic saw numbers dramatically decline in 2020. But at least 30,000 people are still waiting to start treatment. Charities have welcomed the increase in referrals but warned of the "devastating" impact the pandemic has had on cancer care. Referrals for suspected cancer remain at about 16% higher than pre-pandemic levels and rose overall from 2.4 million to 2,65m in the past 12 months. Dame Cally Palmer, national cancer director for NHS England, said there were still 30,000 people who had not started treatment due to the pandemic but that the new figures suggested some progress. She said: "We are going further and faster than ever before in our ambitions to diagnose more cancers at an earlier stage so that we can save more lives." It is "vital that we keep these referral rates high", she added. Read full story Source: BBC News, 2 May 2022
  13. Content Article
    There has been an increasing trend in commercially available diagnostic tests for food allergy and intolerance, but many of these tests lack an evidence base. In this article, Philippe Bégin from the University of Montreal describes the risks involved with using unproven diagnostic tests for food allergies and intolerances. He highlights that alongside their high cost, they may lead to false diagnoses, with associated anxiety and unnecessary strict avoidance diets. They may also lead truly allergic people to believe they are not allergic to certain foods, which could cause them to eat a food that gives them a life-threatening reaction. He also provides a list of tests that are offered to consumers, but that are unproven and should be avoided.
  14. News Article
    NHS leaders are urging people to attend vital lung cancer check-ups as figures reveal almost two-thirds of those invited are not coming forward. The NHS targeted lung health check service offered in some parts of England aims to help diagnose cancer at an earlier stage when treatment may be more successful. Current and former smokers aged between 55 and 74 are invited to speak to a healthcare professional and, if they have a higher chance of developing lung cancer, are offered a scan of their lungs. Doctors are keen to reach those who may not have sought help for symptoms during the pandemic and could be living with undiagnosed lung cancer. People diagnosed at the earliest stage are nearly 20 times more likely to survive for five years than those whose cancer is caught late, according to the NHS. The NHS has already diagnosed 600 people with the disease in travelling trucks, which visit convenient community sites across the UK, such as supermarkets and sports centres, aiming to make it easier for people to access check-ups. But figures show only a third (35%) of patients go to their lung health check when invited by the NHS. “These lung checks can save lives,” said Dame Cally Palmer, the NHS cancer director. “By going out into communities we find more people who may not have otherwise realised they have lung cancer, with hundreds already diagnosed and hundreds of thousands due to be invited." Read full story Source: The Guardian, 19 April 2022
  15. Content Article
    This report by the Health and Social Care Commons Select Committee examines why cancer outcomes in England remain behind other comparable countries. For example, 58.9% of people in England diagnosed with colon cancer will live for five years or more, compared to 66.8% in Canada and 70.8% in Australia. The report identifies key issues in early diagnosis, access to treatment, variation in services and research and innovation, and makes recommendations aimed at improving cancer survival rates in England.
  16. News Article
    More than 200 women were affected by failures in Ireland’s CervicalCheck screening system. It emerged in 2018 that 221 women and families were not told about misreported smear tests. The Minister for Health said that non-disclosure issues which arose in the cervical check screening controversy will be legislated for to prevent it from happening again. Stephen Donnelly said new legislation will address the negligence issues and ensure that the failure to inform the women of the clinical audit of their screening will “never happen again”. Mr Donnelly was discussing a number of amendments at the committee stage of Ireland's Patient Safety Bill. The new legislation will require the mandatory open disclosure of serious patient safety incidents, and sets out a list of incidents which must be reported to the health watchdog, Health Information and Quality Authority (HIQA). Mr Donnelly said that he will introduce an amendment at the report stage of the Bill that will provide for non-disclosure and will deal with issues around delayed diagnosis and delayed screening. Mr Donnelly said: “I’ve had lengthy discussions with the department on this and it doesn’t fit neatly with this Bill because the serious patient safety issues which result in death or serious harm, they are very clear and binary. “Legislating around delayed diagnosis and delayed screening, it is really complex and doesn’t fit neatly in this Bill, however my view is that the non-disclosure that happened in cervical check, even though it doesn’t neatly fit here, should still be legislated for." Read full story Source: The Independent, 11 March 2022
  17. News Article
    Less than half of women are being seen following an urgent breast cancer referral, as NHS performance drops to a new low. ‘Alarming’ new NHS figures have shown just 47% of women in England referred “urgently” for breast cancer symptoms were seen by a specialist within two weeks. For women without symptoms but referred urgently to see a specialist, just 49% were seen within two weeks. In both cases this is the first time since records began that less than 50% cent of women were seen. Within some trusts less than 10% of women referred with symptoms were seen within two weeks, with less than two per cent of women referred to United Lincolnshire Hospitals Trust being seen within this time frame in January. Wes Streeting, Labour shadow health secretary said: “I know from experience the importance of an early cancer diagnosis and quick treatment. It is appalling that most suspected breast cancer patients are left waiting so long before being seen, with the insecurity of not knowing." Baroness Delyth Morgan, chief executive at Breast Cancer Now, said: “It’s alarming that in January, for the first time, less than half of women 47.5 per cent in England who were urgently referred with potential breast cancer symptoms, were seen by a specialist within two weeks." “...the government must consider what immediate steps it can take to reverse this rapid decline. Agonising delays must be replaced with prompt diagnoses for all women – and the sooner breast cancer is diagnosed the greater the chance of treatment being successful.” Read full story Source: The Independent, 11 March 2022
  18. News Article
    A Scottish hospital has become the first in the UK and one of the first in the world to pilot using artificial intelligence (AI) in its cervical cancer screening programme. University Hospital Monklands has increased capacity by around 25% and improved analysis turn-around times with the measure, which experts said could “revolutionise” the screening process. The system, from medical technology company Hologic, creates digital images of cervical smear slides from samples that have tested positive for Human Papilloma Virus (HPV). These are then reviewed using an advanced algorithm, which quickly assesses the cells in the sample and highlights the most relevant to medical experts, saving them time in identifying and analysing abnormalities. “Preliminary results from the pilot are promising, as the team at University Hospital Monklands has increased capacity by around 25 per cent in the slide assessment and improved analysis turn-around times, as well as allowing screeners to dedicate more time to training on the latest technologies and dealing with difficult-to-diagnose cases,” says Allan Wilson, consultant biomedical scientist at NHS Lanarkshire who is leading the pilot. "Through AI and digital diagnostics, we have the potential to improve outcomes for women not only in Scotland, but around the world.” Samantha Dixon, chief executive of Jo’s Cervical Cancer Trust, welcomed the pilot. “Catching cervical cell changes means they can be treated to prevent them from developing into cervical cancer,” she said. Read full story Source: The Scotsman, 4 March 2022
  19. News Article
    Women who have the HPV vaccine may need only one smear test to prevent cervical cancer in their lifetime, according to a leading scientist. Women are currently invited for screening every three to five years in the UK. But Prof Peter Sasieni said the vaccine was leading to such dramatic reductions in cancer that the screening programme would need to change soon. The NHS invites women, and people with a cervix, for regular screening. Swabs of the cervix are used to check for signs of abnormalities using a microscope (the traditional smear test) or more recently to test for the virus itself. However, a seismic shift in preventing cervical cancer started in the UK in 2008 with the introduction of the HPV vaccine. It is offered to girls (and boys since 2019) aged between 11 and 13. Research published in December shows the vaccine is cutting cervical cancer by nearly 90% in those who choose to have the jab. "This is really exciting," Prof Sasieni, the director of the clinical trials unit at King's College London, told Inside Health on BBC Radio 4. His modelling suggests between one and three checks a lifetime would be appropriate for people who have been immunised. "There's a new vaccine which will be used in the UK from the next school year, which protects against even more types of the virus, and I think with that probably one screen would be enough, maybe two, over a lifetime." However, the Department of Health and Social Care said one in three people do not come for screening when invited, and a spokesperson added: "The NHS Cervical Screening programme remains an important way of protecting the population - including those who have not been vaccinated - from developing cervical cancer." Read full story Source: BBC News, 2 March 2022
  20. Content Article
    In this blog for BJGP Life, GP and Public Health Specialty Registrar Richard Armitage looks at the patient safety implications of changes made to gender markers on patient records. Patients in the UK are able to change the gender marker on their NHS patient record on request at any time. This action triggers the creation of a new NHS number and imports the patient’s medical information into a new patient record, without any reference to the patient's previous gender identity or original NHS number. The author highlights that failure to transfer this information could inhibit high quality care for trans patients, especially with regard to population screening programmes which invite patients according to age and gender markers on their patient record. He argues that public health officials, in collaboration with their primary care colleagues, should: respectfully communicate sex-specific health risks with their trans patients encourage them to consider requesting and accessing the appropriate population screening programmes support them in accessing screening in a dignified manner.
  21. Content Article
    Skin cancer is one of the most common cancers worldwide, with one in five people in the US expected to receive a skin cancer diagnosis during their lifetime. Detecting and treating skin cancers early is key to improving survival rates. This blog for The Medical Futurist looks at the emergence of skin-checking algorithms and how they will assist dermatologists in swift diagnosis. It reviews research into the effectiveness of algorithms in detecting cancer, and examines the issues of regulation, accessibility and the accuracy of smartphone apps.
  22. Content Article
    To mark Rare Disease Day 2022, the Department of Health and Social Care has published England’s first Rare Diseases Action Plan.
  23. News Article
    A new pregnancy screening tool cuts the risk of baby loss among women from black, Asian and ethnic minority backgrounds to the same level as white women, research suggests. The app calculates a woman's individual risk of pregnancy problems. In a study of 20,000 pregnant women, baby death rates in ethnic groups were three times lower than normal when the tool was used. Experts say the new approach can help reduce health inequalities. The screening tool is already in use at St George's Hospital in London and is being tried out at three other maternity units in England, with hopes it could be rolled out to 20 centres within two years. Researchers from Tommy's National Centre for Maternity Improvement, led by the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives, developed the new tool. Professor Basky Thilaganathan, who led the research team at St George's Hospital, said the new approach could "almost eliminate a large source of the healthcare inequality facing black, Asian and minority ethnic pregnant women". "We can personalise care for you and reduce the chances of having a small baby, pre-eclampsia and losing your baby," he said. The current system of a tick-box checklist to assess pregnancy risk has been around for 70 years, and is limited. The new digital tool, which uses an algorithm to calculate a woman's personal risk, can detect high-risk women more accurately and prevent complications in pregnancy, the researchers say. Both pregnant women and maternity staff can upload information on their pregnancy and how they are feeling to the app during antenatal appointments and at other times. Dr Edward Morris, president of the Royal College of Obstetricians and Gynaecologists, said it was "unacceptable" that black, Asian and minority ethnic women faced huge inequalities on maternity outcomes. "The digital tool provides a practical way to support women with personalised care during pregnancy and make informed decisions about birth. Read full story Read Tommy's press release Source: BBC News, 28 February 2022
  24. Content Article
    The aim of this study from Liu et al. was to assess the impact of the Fetal Medicine Foundation (FMF) first trimester screening algorithm for pre-eclampsia on health disparities in perinatal death among minority ethnic groups.
  25. News Article
    Breast cancer screening uptake fell to its lowest point ever during the pandemic, as the numbers of women seen dropped by more than one third. Just 1.19 million women aged 45 and over were screened for breast cancer in 2020-21, while the numbers of women who actually took up their invitation for screening dropped to 61%. Analysis by Breast Cancer Now, of the new NHS figures published on Thursday, found that uptake during the first year of the pandemic was the lowest it had been since records began. The number of women who had cancer detected through screening decreased by almost 40 per cent, although rates when calculated per 1,000 women were up by 8.4%. The news comes after NHS figures revealed that half of patients in October waited more than two weeks following an urgent breast cancer referral. According to analysis from the Labour Party in January, breast cancer patients faced the longest waits when compared to all other cancer referrals. Breast Cancer Now chief executive Baroness Delyth Morgan said: “Screening uptake has hit its lowest point in history, with less than 62% of women invited being screened, despite NHS staff working tirelessly, in the toughest of circumstances, to restart and continue breast screening services after they needed to be paused in March 2020. “The human cost behind these figures is stark, with an estimated 8,870 women in the UK living with undetected breast cancer as a result of the pandemic – a significant number of which would have been detected at routine screening. Tragically, research suggests that up to an additional 680 women could die from breast cancer in the next decade due to impacts of the pandemic on screening.” Read full story Source: The Independent, 24 February 2022
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