This document discusses improving cancer outcomes in Camden. It provides statistics showing that early stage diagnosis leads to much higher 5-year survival rates for cancers like breast and colorectal. While Camden has seen faster reductions in cancer rates than England and London, it has a higher proportion of late stage diagnoses. The document outlines several initiatives to improve early diagnosis and communication between primary and secondary care, implement best practice pathways, and support patients presenting late. It focuses on increasing educational opportunities, linking to awareness campaigns, reflecting on current practices, and strengthening primary-secondary care interfaces.

1. Improving Cancer Outcomes in
Camden
Dr Lucia Grun
19 March 2014

2. International Cancer Benchmarking Partnership: 5 year relative
survival, patients diagnosed 1995-2007: Coleman et al, Lancet 2011

3. International Cancer Benchmarking Partnership: 5 year relative
survival, patients diagnosed 1995-2007: Coleman et al, Lancet 2011

4. Cancer Late stage five year
relative survival
Early stage five year relative
survival
Breast 13% (IV) 92% (I)
Lung – Non-small cell 2-13% (4) 58-73% (1A)
Colorectal 6.6% (Dukes D) 93.2% (Dukes A)
Five year survival of common cancers diagnosed
Early versus late

5. Camden-specific statistics…
Directly standardised mortality rate aged under 75 for all cancers, Camden, 1993-2011
Source: Health and Social Care Information Centre, 2013, NB data for 2009-11 are provisional at the time of publication.
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6. Camden-specific statistics…
• The reduction in Camden’s cancer rates has been faster over the past 10
years (27%) than England (22%) or London (25%)
• May relate to greater than average reduction in numbers of smokers in
Camden
• In Camden, a higher proportion of people are diagnosed at stage 1 (34%)
compared to neighbouring boroughs and the London average.
• Camden also has a significantly higher proportion of cancers diagnosed at
stage 4 (late) compared to the London average
Camden Joint Strategic Needs Assessment 2013, Camden Council http://www.camden.gov.uk/ccm/content/social-care-
and-health/health-in-camden/joint-strategic-needs-assessment-2012/chapter-16-cancer.en?page=3
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7. National Patient Experience Survey for all cancers
Question 64: Practice staff definitely did everything they could to support patient
Trusts 2012 2013
BCFH 60.92% 65.88%
BHRUT 60.50% 59.31%
HUH 76.67%
NMUH 53.80% 57.54%
PAH 62.55% 62.84%
RFL 60.55% 63.82%
RNOH 48.89% 70.21%
UCLH 57.10% 55.92%
WH 60.00% 61.43%
BH 58.53% 62.39%
Data
Source:
National
Cancer
Patient
Experience
survey
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8. 3 year funded
project Camden
CCG and London
Cancer
Delivered through
other workstreams

9. Improving outcomes for Camden patients
Improve earlier diagnosis of cancer
•Developing educational opportunities
o Online learning package
o Integrate results of recent GP questionnaire
•Linking into national awareness campaigns
•Reflection on current practice through various methods
•Best Commissioning Pathways from NHS England
Improve communication
•Interface between primary and secondary care
•Facilitate connections between practices and CCG
•London Cancer as a way to support this
Improve pathways for patients who present late
•Learning from the A&E Audit

10. • Encourage stronger links into national awareness campaigns
o Awareness of key messages
o Available leaflets and promotion
in practices
• Access to appointments
o Patient perceptions
• Uptake in screening programmes
o Cervical
o Bowel
o Breast
Earlier Diagnosis – Practice based

11. • Education of reception staff
• Appropriate use of 2ww referral between primary and secondary care
• Creating a low risk but not no risk culture
Earlier Diagnosis - Communication

12. Earlier Diagnosis - Reflection
• Significant event analysis
• Audit of past cancer diagnoses
o Understand patient journey and route to diagnosis
o Upcoming audit
• Sharing learning within practices and localities
o Best practice and insights across Camden
• Using practice profiles
o Available at today’s event
• MacMillan Risk Assessment Tools

13. Best Practice Pathways for early detection

14. Numbers of ovarian cancers detected in a theoretical cohort of 100,000 with
symptoms consistent with ovarian cancer presenting to primary care
Assumed prevalence of undiagnosed ovarian cancer is 0.23% in women with such symptoms- total numbers of
ovarian cancer cases is 230
Source: Transforming Cancer Services for London, Best Practice Commissioning Pathway for the early detection of ovarian
cancer , NHS England