What do we mean when we say ‘early diagnosis’?

We know that if cancer is diagnosed at an early stage, it is often more likely to be treated successfully and give a better experience for patients overall. 

Diagnosing cancer early means treatments can sometimes prevent spreading or growth of the disease. Having a delay in diagnosis can mean that treatment are more difficult and reduce the chance of a positive outcome; including survival rates for some cancers.

A priority for the Cancer Alliance is to improve the outcomes and experiences for cancer patients by encouraging early diagnosis. 

We often talk about reducing inequalities too; what we mean by this, is that that we know some people in our communities are less likely to go to the GPs or access healthcare to allow early diagnosis and as such it means they often have poorer outcomes and less chance of survival and recovery. Our priority here is to reduce this gap and promote access for all to ensure early diagnosis.

Why does early diagnosis not happen?

Some people may be put off seeing a doctor for example, through fear of what they may find but our advice is to come forward and get things checked out. We have a lot of exceptional doctors and nurses trained to support you in accessing care and a lot of the time, there is no need to worry. It can be a very reassuring process but we do recognise it can be scary too.

Sometimes people don’t come forward because they don’t know the signs and symptoms of cancer or there are delays in referrals for further tests or treatment.

Earlier and faster diagnosis is dependent on people understanding and being aware of the early signs and symptoms of cancer, by taking up screening programmes or visiting a healthcare professional.

What do we do?

We work closely with GPs, clinicians, charities such as Macmillan and CRUK, voluntary organisations, patients and the public to identify and employ a range of ways to support early diagnosis. 

How does it affect patients?

Through all our projects, our aim is to work in partnership to increase the number of people being diagnosed at an early stage and reduce the number of patients diagnosed as an emergency so that outcomes are improved.

You can learn more about inequalities and early diagnosis through our professionals' area or by emailing linda.kaye2@nhs.net

Our work includes:

Be Cancer SAFE

Be Cancer SAFE is a community approach to improving cancer survival in South Yorkshire, Bassetlaw and North Derbyshire.

More people in our region are diagnosed with cancer than the England average and we know that catching cancers at an earlier stage greatly increases the chance of survival.

Through a range of community based activities, such as attending coffee mornings, galas, talking to local businesses, we aim to make sure everyone is aware of the signs and symptoms of cancer, know what screening is available to them and ultimately increase the number of people diagnosed at an earlier stage.

Ordinary members of the community can get involved and be supported to raise awareness with their family, friends, neighbours and work colleagues. They will do this by word of mouth, distribution of information and signposting people to the range of services available to them. They will assist in giving information which is beneficial to others and motivate people to be more aware and alert to cancer symptoms.

Be Cancer SAFE is coordinated by South Yorkshire, Bassetlaw and North Derbyshire Cancer Alliance and delivered by the following voluntary sector and health organisations in each area: 

Follow us on social media:

Facebook – www.facebook.com/groups/BeCancerSafe/

Twitter - @SYBhealthcare #becancersafe

QUIT Smoking Cessation

In SYB, the average rates of smoking-attributable deaths in England are much higher than the England average (319.5 per 100,000 compared to an England average of 272.0 per 100,000)

The estimated cost to the public of smoking in SYB is £388 million - if we take account of output lost from early deaths, provision of NHS treatment, provision of social care, smoking breaks, sick days, household fires and passive smoking

Smoking is the single largest cause of ill health and preventable death in England and kills about half of all lifetime users

The QUIT programme is based on four steps:

Q – ask the question: all hospital patients should be asked if they are a current smoker.

U – understand their addiction: all hospital patients should be asked to exhale into a CO monitor and their result noted in patient records.  This provides not only evidence of the conversation taking place, but provides a strong indicator of level of addiction which will support and indicate further treatment, but also contributes to triggering quit attempts.

I – inform patients about smokefree sites: all patients should be informed that the hospital site is smokefree and that patients and visitors are not permitted to smoke anywhere on site, but that they can access support for nicotine replacement.

T – initiate treatment: refer patients to smoking cessation support including advice and treatment as soon as possible, enabling them to quit during their inpatient stay where possible and ensuring appropriate ongoing support after discharge. Patients should be offered nicotine replacement support within 6 hours of arrival on the ward.

Education Events for Primary Care

The Cancer Alliance contributed to Primary Care education events across the area during 2018 to provide information and gather feedback on new pathways, tests, initiatives focusing on improving early diagnosis of cancer and  highlight the work of the Alliance.

In 2019, we organised a head and neck cancer study morning for all primary care staff on 22 June. You can find out more in our information leaflet.

In partnership with CRUK and the Royal College of General Practitioners, a Primary Care and Cancer Matters workshop for GPs was held on 6 November 2019. 

FIT for low risk symptomatic patients

Introduction of FIT as a Primary Care Diagnostic Support Tool

Faecal Immunochemical Test (FIT) is a new test for certain groups of patients with a low risk of colorectal cancer but presenting with symptoms. These patients don’t meet the criteria for a suspected cancer referral pathway but are experiencing symptoms.

We have introduced the test into GP Practices across the Cancer Alliance so patients can start benefitting from the new, more sensitive test. An abnormal FIT result suggests that there may be bleeding within the lower gastrointestinal tract and should lead to referral for further investigation.

Patient information leaflet

FIT kit contents.jpg


Vague Symptoms Pathways

Vague Symptoms pathways were developed for patients with non-specific but concerning vague symptoms. The aim is to provide more structured rapid diagnostic pathways for these defined groups of patients in order to:

·        Diagnose or exclude cancer and other conditions earlier

·        Reduce the number of patients that present as emergencies or with late stage disease

·        Improve patient experience and outcomes for patients with symptoms of: Weight loss / recurrent abdominal pain / suspicious but non-specific abdominal pain

The nature of the symptoms i.e. vague or non-specific, makes it challenging to identify the more appropriate referral pathway first time. As a result, patients may be referred on to a number of pathways before the correct diagnostic tests are applied and a diagnosis is made. This can result in a longer time to reach a diagnosis which can impact on the outcomes and experience for a patient. Many patients with NSCS present at A&E and consequently their outcomes are usually poor.

Vague symptoms referral pathway projects have been implemented across Chesterfield, Rotherham, Doncaster, Bassetlaw and Barnsley.

Learning Event Analysis

Learning Event Analysis (LEA) is an approach to quality improvement in general practice. It involves a structured review of all that happened in relation to an ‘event of interest’, which may be adverse, exemplary or simply important. The requirements of the Care Quality Commission, annual appraisal and revalidation are increasing emphasis on the quality of continuing professional development and reflective practice.

Cancer LEAs prompt GPs to reflect on their diagnosis and identify any potential improvements in practice systems using documentation or proactive safety netting.

GPs should be required to undertake a Significant Event Analysis for any patient diagnosed with cancer as a result of an emergency presentation. A key part of the strategy includes reducing emergency presentations of a new diagnosis and deciphering whether there are specific avoidable contributors; currently just over 20 per cent of all cancers in England present via this route

Safety Netting may support healthcare professionals to detect cancers earlier and minimise delayed diagnoses. It is a technique which can be used to ensure the timely re-appraisal of a patient's condition. This is important for conditions such as a suspected cancer where patients present infrequently with common and often non-specific conditions. CRUK supports this work with the facilitators who work with Practices on this.

Lynch Screening

Lynch syndrome is a genetic condition which predisposes those affected to develop cancers such as colorectal, endometrial, ovarian, gastric, skin and brain cancers, often at a relatively young age. Affected individuals are otherwise healthy and hence are unaware that they have the condition until a cancer develops.

It is estimated that 175,000 people in the UK are affected by Lynch Syndrome and that 1,100 colon cancers which occur each year are attributable to the condition (3.3%).

There is no universal screening programme for Lynch Syndrome. Since 2017 NICE have recommended that all patients with colorectal cancer should be tested to assess whether the tumour may have arisen because of Lynch Syndrome. This identifies individuals at risk of having Lynch Syndrome, for whom further testing and assessment at a Clinical Genetics clinic can confirm (or exclude) the diagnosis. If confirmed, risk-reducing strategies can be offered to allow early diagnosis of further cancers, both for the patient and for relatives.


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