Diagnosing cancer earlier and faster

Cancer survival rates in England are higher than they have ever been and earlier diagnosis is a key part of improving survival rates further.

The Long Term Plan continues to expand upon our work to transform cancer care so that from 2028, an extra 55,000 people each year will survive for five years or more following their cancer diagnosis and three in four cancers (75%) will be diagnosed at an early stage.

Earlier diagnosis is critical to meeting our survival ambition, as it means patients can receive treatment when there is a better chance of achieving a complete cure. Information on progress made on achieving early and faster diagnosis is provided below:

Cancer Alliances

Cancer Alliances are the driving force for change, providing dedicated focus and capacity to deliver improvements in cancer outcomes locally.

Early detection – Be Clear on Cancer

Be Clear on Cancer campaigns aim to improve early diagnosis of cancer by raising public awareness of signs and/ or symptoms of cancer, and to encourage people to see their GP without delay. The programme is led by Public Health England, working in partnership with the Department of Health and NHS England.

The National Cancer Registry and Analysis Service evaluate the campaigns and the results of previous campaigns.

Early detection – new screening tests

Bowel Cancer screening

Bowel cancer is the fourth most common cancer in the UK. If it is detected at an early stage, before symptoms even appear, it is easier to treat and there is a better chance of survival. NHS England has introduced a new bowel cancer screen test for over 4 million people that is easier to use than the previous test.

We expect the new faecal immunochemical test for haemoglobin (FIT) to increase the take up of bowel cancer screening by around 7%. In trials using FIT we saw more men, people from ethnic minority backgrounds and people in more deprived areas take up the offer of screening for bowel cancer. With up to a third-of-a-million more people expected to self-administer the FIT test, it will increase the number of early-stage bowel cancers that are detected.

HPV:

More than 99% of cervical cancers are caused by Human papilloma virus (HPV). The introduction of primary HPV testing for cervical cancer will see more than three million women a year tested and could prevent around 600 cancers a year.

Rapid Diagnostic Centres

Rapid Diagnostic Centres (RDCs) are designed to speed up cancer diagnosis and support our ambitions to achieve earlier diagnosis, with improved patient experience, for all patients with cancer symptoms or suspicious results.

The Long Term Plan calls for the roll-out of new RDCs that bring together modernised kit, expertise and cutting edge innovation, building on 10 models piloted with Cancer Research UK and Macmillan. These centres will begin by focussing on diagnosing patients with non-specific symptoms and who may go to their GP many times before being sent for tests.

We are setting an ambitious five-year vision for RDCs. In time, they will offer a single point of access for all patients with suspected cancer. They will offer a personal, accurate and fast diagnosis service, with excellent patient experience.

A national evaluation will be conducted to further understand the impact of RDCs on patient outcomes and inform national policy development.

7 key components of an RDC

Rapid diagnostic centres include the following components

  • Early identification
  • Timely referral
  • Symptom assessment
  • Coordinated testing
  • Timely diagnosis
  • Onward referral
  • Patients will receive excellent coordination and support throughout this process.

Faster Diagnosis Standard

The new Faster Diagnosis Standard will ensure that all patients who are referred for the investigation of suspected cancer find out, within 28 days, if they do or do not have a cancer diagnosis. This standard will be introduced in April 2020.

Hospitals are recording data in 2019, which will help us to understand current performance in England. It will enable Cancer Alliances to identify where improvements need to be made before the standard is introduced.

This new standard should help to:

  • Reduce anxiety for patients who will be diagnosed with cancer or receive an ‘all clear’ but do not currently hear this information in a timely manner;
  • Speed up time from referral to diagnosis, particularly where faster diagnosis is proven to improve clinical outcomes; and
  • Reduce unwarranted variation in England by understanding how long it is taking patients to receive a diagnosis or ‘all clear’ for cancer across the country.

To prepare for the Faster Diagnosis Standard, NHS England introduced a new Cancer Waiting Times System in April 2018. The system now collects data for the Faster Diagnosis Standard, in addition to other cancer access standards, on a monthly basis. Cancer Waiting Times Guidance (v10) was published in April 2019 to explain how providers should record data in the new system, using the updated dataset (v2.0).

Cancer Workforce Plan

The Cancer Workforce Plan has been jointly developed by NHS England, Health Education England and other key partners. It sets out a delivery plan to ensure the NHS in England has the right numbers of skilled staff to provide high quality care and services to cancer patients at each stage in their care.

Targeted Lung Health Checks

Lung cancer scanning trucks that can operate from supermarket car parks are being rolled out across the country in a drive to save lives by catching the condition early.

Around £70 million will fund 10 projects that check those most at risk, inviting them for an MOT for their lungs and an on the spot chest scan that include mobile clinics. As part of the assessment, staff will also provide help and advice on stopping smoking.

The targeted screening will help improve survival rates by going first to the some of the areas with the highest death rates from lung cancer.

Targeted Screening for Lung Cancer with Low Radiation Dose Computed Tomography Standard Protocol