national perspective cancer early detection & prevention performance review event october 2008...
TRANSCRIPT
National Perspective
Cancer Early Detection & Prevention Performance Review Event
October 2008
National Cancer Action Team
Kathy Elliott
National Lead for Prevention, Early Diagnosis and Inequalities
Cancer Reform Strategy
Preventing cancer• Over half of cancers could be prevented by changes to
lifestyle• Smoking, obesity, alcohol, sun & sun beds, vaccination
Diagnosing cancer earlier• Late diagnosis is the major factor contributing to poor
cancer survival rates in England• Screening – cervical, breast, bowel
Reducing cancer inequalities• Major inequalities in cancer incidence, access to
services and outcomesNational Cancer Action Team
Initial Priorities
• Building links with Cancer Networks and PCTs– PCT Strategic Commissioning Plans– Cancer mortality reductions– Early detection agenda
• Input to Commissioning Guidance and Darzi alignment
• Skin cancer – 08/09 procurement decisions• National Initiatives – NAEDI and NCEI
National Cancer Action Team
08/09 CAT Work programmePreventing Cancer• Study of sun bed use• New local & national approaches for skin cancer prevention• Dissemination – pilots to assess cancer genetic risks
Diagnosing Cancer Earlier• Support Networks to
– Review the local indicators to early diagnosis– Set out commissioning intentions in PCT Strategic Plans– Develop at least one new initiative for implementation locally– Use new tools and good practice
Reducing Cancer Inequalities• Equality Impact Assessments• Cancer mortality
National Cancer Action Team
New ways of working
Local priorities reflecting local needs & services
National experts
Sustainable effective services
Local & national leadership
Top down National targets
Short term projects
The Importance of DialogueNational Cancer Action Team
National Awareness and Early Diagnosis Initiative (NAEDI)
Co chairs: Harpal Kumar and Mike Richards
7 work streams
Review of evidence base on awareness and early diagnosis Measuring awareness Interventions to promote early presentation by patients Interventions in primary care International benchmarking Prospective research Key messages on individual cancers
Launch conference: 21st November 2008
Newsletter
Reducing Cancer Inequalities National Cancer Equality Initiative
Co chairs: Joanne Rule and Mike Richards Steering group with experts from each of the inequality
strands (e.g. race, age, gender, disability, religion, sexual orientation and social deprivation)
Working closely with National Awareness and Early Diagnosis Initiative (NAEDI) and with National Cancer Intelligence Network (NCIN)
Developing a matrix of local initiatives Please contribute
Will then focus on: Spreading good practice where this exists Developing and evaluating new models to reduce inequalities
Cancer Networks• Understanding and communicating local need
– Joint Needs Assessment (JNAS)
• Providing leadership for prevention, early detection and inequalities– Influencing
• PCT Strategic Plans – Monitoring and assuring quality and outcomes
• Vital Signs and Local Area Agreements• CRS commitments – mortality; inequalities
– Development• Early detection initiatives
– Network expertise and work plan • Good practice – spread of community engagement in early detection• Development needs
• Challenges
National Cancer Action Team
Diagnosing Cancer Earlier
• To have reviewed information – One year survival rates against international
benchmarks– Screening uptake, overall and by general practice– Referral rates, by general practice– Emergency admission
• In PCT Strategic Commissioning Plan• At least one initiative implemented• National Awareness and Early Diagnosis
Initiative
Every PCT should have one early diagnosis/ detection initiative.
National Cancer Action Team
Cancer Mortality
• What local progress has been made towards achieving the cancer mortality target?
• How does this compare with the England progress, other Networks/ PCTs?
• What is my local commitment to meet the 2010 standard?
• ‘Have PCTs agreed challenging goals for reducing cancer mortality in every cancer network area by 2012?’ (CRS)
• Are these goals in the PCT Strategic Commissioning Plans - and resourced?
• Do local plans reflect variations between PCT needs and health inequalities?
National Cancer Action Team
0
20
40
60
80
100
120
140
160
1993/4/5 1995/6/7 1997/8/9 1999/2000/1 2001/2/3 2003/4/5 2005/6/7 2007/8/9 2009/10/11
Source: ONS (ICD9 140-209; ICD10 C00-C97)
Rates are calculated using the European Standard Population to take account of differences in age structure.
ICD9 data for 1993 to 1998 and 2000 have been adjusted to be comparable with ICD10 data for 1999 and 2001 onwards.
Cancer Mortality TargetDeath rates from All Cancers in England 1993-2007 and target for the year ‘2010’Persons under 75
Death rate per 100,000 population
3 year average
Target:
20%minimum reduction from1995-97 baseline rate
baseline Progress target
141.2
113.0
SAVING LIVES
115.5
Progress since baseline:
A fall of 18.2%
0
20
40
60
80
100
120
140
160
1993/4/5 1995/6/7 1997/8/9 1999/2000/1 2001/2/3 2003/4/5 2005/6/7 2007/8/9 2009/10/11
Source: ONS (ICD9 140-209; ICD10 C00-C97)
Rates are calculated using the European Standard Population to take account of differences in age structure.
ICD9 data for 1993 to 1998 and 2000 have been adjusted to be comparable with ICD10 data for 1999 and 2001 onwards.
Cancer Mortality TargetDeath rates from All Cancers in England 1993-2007 and target for the year ‘2010’Persons under 75
Death rate per 100,000 population
3 year average
Target:
20%minimum reduction from1995-97 baseline rate
baseline Progress target
141.2
113.0
SAVING LIVESSAVING LIVES
115.5
Progress since baseline:
A fall of 18.2%
100
110
120
130
140
150
160
170
180
1993/4/5 1995/6/7 1997/8/9 1999/2000/1 2001/2/3 2003/4/5 2005/6/7 2007/8/9 2009/10/11
Age standardised mortality ratePer 100,000 population
Target:
6%minimum reduction in absolute gap, from1995-97 baseline
baseline Progress target
20.7
Cancer mortality in people under age 75 – Inequality gapEngland 1993-2007 and target for the year ‘2010’
3 year average
18.0
19.5
England
SpearheadGroup
Inequality Gap in rate*(deaths per 100,000 population)
TargetProjection of cancer mortality for England
Target reduction for Spearhead Group i.e. to achieve target* The absolute gap between rate for England and rate for Spearhead Group (in deaths per 100,000 population)
0
Actual Data
Source: ONS (ICD9 140-209; ICD10 C00-C97)
(exponential projection based on data for the 10 years 1998-2007)
reduction in gap given observed/projected England rate
Progress since baseline:
A fall of 13.2% in the gap
100
110
120
130
140
150
160
170
180
1993/4/5 1995/6/7 1997/8/9 1999/2000/1 2001/2/3 2003/4/5 2005/6/7 2007/8/9 2009/10/11
Age standardised mortality ratePer 100,000 population
Target:
6%minimum reduction in absolute gap, from1995-97 baseline
baseline Progress target
20.7
Cancer mortality in people under age 75 – Inequality gapEngland 1993-2007 and target for the year ‘2010’
3 year average
18.0
19.5
England
SpearheadGroup
Inequality Gap in rate*(deaths per 100,000 population)
TargetProjection of cancer mortality for England
Target reduction for Spearhead Group i.e. to achieve target* The absolute gap between rate for England and rate for Spearhead Group (in deaths per 100,000 population)
0
Actual Data
Source: ONS (ICD9 140-209; ICD10 C00-C97)
(exponential projection based on data for the 10 years 1998-2007)
reduction in gap given observed/projected England rate
Progress since baseline:
A fall of 13.2% in the gap
Relative change in mortality rates and the level of change in mortality rates since 1997 (compared to England level) by cancer network.5 year rolling age-standardised mortality rates (2001-2005) for all cancers for 0-74 years age group; % change in mortality rates since 1997
Relative change in cancer mortality by cancer network since 1997
"Good"
"Good"
National Cancer Action Team
Emerging Good Practice Themes
• Priority within local plans, including pledges• Leadership commitment and ownership, with
clarity on why it matters– Reductions in mortality – Fair access to services
• Strong public and patient involvement• Relationship management and communications
– Close working with other networks, with explicit commitments
– Building a relationship with public health – engagement, influence and work programme
– Importance of all health professionals understanding their role and implementing their contribution
• 2 year action plan National Cancer Action Team
Kathy ElliottNational Lead for Prevention, Early Diagnosis and InequalitiesNational Cancer Action Team
Blackberry and [email protected]
Office 0207 972 [email protected]
Note – please use both email addresses
National Cancer Action Team