NewsleTTer. ISSUe 9 DETECT CANCER EARLY. NHS Ayrshire and Arran. Breast. Lung. Training. Bowel

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1 DETECT CANCER EARLY NewsleTTer. ISSUe 9 NHS Ayrshire and Arran. In NHS Ayrshire & Arran we continue to work across the campaigns delivering the Detect Cancer Early message in a variety of innovative ways to our target groups. The summary below gives a flavour of some of the work that we have been involved in recently. Breast During October, breast cancer awareness month, we were speaking to women in a variety of locations including local bingo halls. We have spoken to around 450 women so far and provided them with information on the new screening campaign. The thingymaboobs has been a great success in visually giving people an understanding of the importance of screening. presentation accepted for the Public Health Conference in November promoting alternative methods of speaking to harder to reach individuals. We have also been out to local companies including builders, garages and taxi companies distributing posters and other promotional items targeted at men, taking the opportunity to speak to them about the importance of bowel screening. Lung We are about to start our second round of visiting targeted pharmacies to speak to staff and customers about the campaign and raise awareness of the signs and symptoms. Training We were fortunate to be able to attend the Breast Cancer Care Train the Trainer session earlier in the year and we have delivered 11 Breast Awareness sessions so far in a variety of settings. Funding has been secured to develop a Detect Cancer Early module for Learnpro that will promote all of the campaigns to date. This is in progress and will be forwarded to key people in the near future for feedback. From left to right: Jane Johnstone, Gala Bingo Manager; Kay Cooper, Senior Health Promotion Officer, NHS A&A; Irene Newlands, Gala Bingo Staff Member. Bowel We completed our work with William Hill where we spent time at targeted stores speaking to men about bowel screening and we have had a poster We are also developing a toolkit for other staff to support them in delivering key messages from the Detect Cancer Early campaigns with their client groups; this is based on the needs of local Homeless Nurses but could be used with a wide range of staff. Gillian Jennings Health Promotion Officer: Detect Cancer Early

2 Cancer Research UK/NHSGGC Primary Care Engagement (PCE) Programme. Established in June 2014, the PCE programme is a 3 year partnership between NHS Greater Glasgow & Clyde and Cancer Research UK which will provide NHSGGC primary care practitioners with practical support, information and educational resources to improve cancer outcomes (focusing on early diagnosis and prevention). This includes a tailored Practice Pack and dedicated facilitator time to address the cancer issues raised by that practice. 3 facilitators have been recruited to support practices, and over 50 practices have received an individual visit from their dedicated facilitator. At these visits, practices have accessed support and resources such as: Delivery of Bowel Screening Awareness Training; short quizzes and information sessions at team meetings to raise awareness amongst all practice staff about the bowel screening programme to support achievement of sgms Bowel Screening contract initiative. Sharing information around cancer resources for professionals (e.g. cancer audit tool, risk assessment tools and safety netting checklist) and support services for patients. Following the visit, practices have: Undertaken a cancer audit (using the RCGP template provided by facilitators) in order to understand cancer patient demographics, presenting symptoms and diagnostic and referral pathways. Written up cancer Significant Event Analysis and identified lessons learned for the practice and the wider system. Revised their sgms bowel screening initiative action plans to incorporate additional engagement activity shared by the facilitator. If you would like further information about the PCE team, please contact Marion O Neill via marion.o neill@ggc.scot.nhs.uk or telephone Marion O Neill Primary Care Engagement Facilitator Manager

3 NHS Dumfries and Galloway. Community Development Workers are on board. They have been provided with materials displaying key messages that can be given out while they are working in communities throughout the region. In addition they have added campaign images and straplines to the Building Healthy Communities blogspots. The online blogs are a great platform for communicating key messages about signs and symptoms and getting to your GP as soon as possible. Along with key messages they have added details of where to find out more information should someone accessing the blogspot have a concern about themselves, family or friends. Communication and Engagement Officer for Detect Cancer Early, Kirsten Moffat said: Community Development Workers in Dumfries and Galloway have shown a keen interest and a real understanding of the importance of the campaign. The kind of pro-active support they provide is invaluable in reaching some of our target audiences. Lead clinician for lung cancer Paul Rafferty and lead cancer GP Peter Hutchison have been interviewed about the importance of early detection of the disease. They talked about the difference that can be made if lung cancer is caught early and about the range of treatments available. The reporter highlighted the important link between GPs in the region and staff at Dumfries and Galloway Royal Infirmary, and that they are working hard to catch lung cancer early in the 80 to 100 people diagnosed in the region each year. The local newspaper article complemented Scottish Government ads in national newspapers and broadcast on local radio throughout the month of November, and included the Alex Ferguson image with key message - if you ve had a cough for three weeks, see your GP. Kirsten Moffat Communication and Engagement Officer DCE From left: Claire Drummond, Cancer Information & Support Centre Manager, NHS D&G; Dr Paul Rafferty, Lead clinician for lung cancer, NHS D&G; Dr Peter Hutchison, lead cancer GP for NHS D&G.

4 An Innovative Approach to Screening for the Suspicion of Lung Cancer. The Clock is Ticking Fiona Duff DCE Lung Cancer Strand Project Manager; Dr Neil Pryde, Lead Cancer GP; Dr Colin Selby, Respiratory Consultant; Jeanette Burdock, Superintendent/Radiographer. Background The Detect Cancer Early HEAT target is aimed at increasing the proportion of people diagnosed and treated in the first stage of breast, colorectal and lung cancer by 25% by 2014/15. For both males and females combined, lung cancer persists as the most common cancer, with 17% of all cancers diagnosed in 2011 being lung compared to 15% and 13% respectively for breast and colorectal. Aims 1. To explore the possibilities of routine screening for suspicion of lung cancer through a community based programme targeted within areas of socioeconomic deprivation. 2. To prevent future generations of lung cancers through risk awareness and harm reduction. Methodology 13 GP practices across NHS Fife have committed to piloting the service. A screening tool and pathway have been devised incorporating The Scottish Referral Guidelines for Suspected Cancer. During either Keep Well or Stop Smoking consultation, patients registered at any of the 13 practices are offered screening for the suspicion of lung cancer. Both Keep Well and Stop Smoking services have a targeted health inequalities approach within the 40% most deprived postcodes in accordance with the Scottish Index of Multiple Deprivation. Current or ex-smokers showing signs or symptoms that may be suspicious of lung cancer are subsequently referred for chest X-ray with follow-up at GP practice in 5-7 days. If no abnormality is detected at X-ray and symptoms remain, GP s will implement any further investigation required. Non-smokers who have never smoked (classified as Never Smokers ) showing signs or symptoms that may be suspicious of lung cancer are referred directly to GP practice in 5-7 days for GP directed investigation. Results To date (Feb Oct 2014) 102 people have been found to have signs or symptoms that may be suspicious of lung cancer, and has resulted in referral. A small scale test of change pilot resulted in 5 current smokers and 2 ex-smokers being referred direct to GP for investigation75 (38 current and 37 ex-smokers) have been referred direct to radiology for chest X-ray. 19 never smokers have been referred direct to GP for investigation. REFERRAL OUTCOMES Find lung cancer early and you could get some extra time. These days, lung cancer doesn t have to be a death sentence. People do survive it. And the earlier it s found, the more that can be done, even if it s just to treat your cough or help you breathe easier. If you re worried about any changes to your cough, chest or breathing, make an appointment with your GP as soon as possible. Don t get scared, get checked. getcheckedearly.org Why Detect Lung Cancer Early? Number and percentage of patients by stage at diagnosis for lung cancer (Fife 2013): 5 year survival at stage of diagnosis for lung cancer: Why Focus on Areas of Socioeconomic Deprivation? Smoking is the main causative factor for around 86% of lung cancers. Smoking prevalence is around 2.5 times higher in deprivation areas compared to areas of affluence. 15% 16% 34% 8% 18% 74% No FH 1st degree 2nd degree 12% 2% 7% 14% 22% 15% 21% Confirmed COPD New Asthma Background Changes Other Pending Of Note 26% of those referred had a family history of lung cancer (this can increase risk by 50%). 14% of those referred commenced smoking aged 12 years or under (this can be more harmful than starting as an adult). 13% of current smokers have a new recorded NRT prescription and documented quit following chest X-ray (this can reduce lung cancer risk by %). FAMILY HISTORY OF LUNG CANCER NAD DNA AGE COMMENCED SMOKING 14% 28% 12 yrs & under yrs yrs 19 yrs & above Unknown Conclusion Although there has been no new lung cancer diagnosis as yet, other respiratory related illness has been diagnosed, and all referrals have been deemed appropriate. An unexpected benefit from screening has been the increase in quit attempts from smokers who had previously shown no desire to stop smoking during Keep Well consultation. Recommendations Roll out to all GP practices across NHS Fife. Provide stop smoking intervention for those showing background changes. Provide intensive stop smoking and behavioural change intervention for those with confirmed COPD diagnosis. Follow up those who failed to attend for chest X-ray. Contact Fiona Duff f.duff@nhs.net / Dr Neil Pryde Cancer Services Lead Macmillan Lead Cancer GP

5 Update on Detect Cancer Early Campaign. The last quarter of 2014 was a busy time for the Detect Cancer Early social marketing team November saw the roll-out of the refreshed lung cancer campaign, fronted by Sir Alex Ferguson, but with a new call to action: if you ve had a cough for three weeks, see your GP. The launch photocall at Glasgow s Buchanan Galleries used five-foot illuminated letters spelling out COUGH as the backdrop for local GP, Douglas Rigg, to highlight the fact that Scots are 20 times more likely to survive lung cancer if it s detected at an early stage. Boards have been monitoring chest X-ray referral rates during the campaign period and beyond these will be analysed in February alongside other campaign measurements to get a full understanding of the impact. Meanwhile, October saw the bowel screening campaign go live for four-weeks with a new, powerful call to action that reinforced the value of taking the test: when bowel cancer is found early it can often be cured. Following the campaign, almost four in ten (37%) of 45+ C1C2DEs strongly agreed that if bowel cancer is detected early, it can often be cured. Considering this was the first time the message had been adopted, and only featured in press and on radio, it s a very positive sign. It was also revealed shortly afterwards that there was around a 9% increase in the number of kits returned during the campaign period, compared to the equivalent period in The team is now looking at what learnings can be built on moving forward to further increase this figure. To coincide with breast cancer awareness month in October, screen star photocalls were organised in areas with low uptake of breast screening in the West and South East, to inform local women about the breast screening process and encourage those who have missed an appointment in the last two years to reschedule. Screen stars saw local women who regularly attend breast screening lending their name to a recreated Hollywood Walk of Fame usually only featuring women of a different kind of screen. Media have been loving the prop! Susan Dunn, Breast screening participant

6 SUPPORT THE Campaign. If you haven t already seen it, getcheckedearly.org has had a makeover. It now features information on tumour types that aren t covered by the DCE programme, but there are currently no plans to run campaigns around them. We re always looking for human interest stories to share in support of the campaign. So, if you know anyone who has completed their bowel screening test for the first time recently or encouraged someone they know with a persistent cough to visit their GP, we want to hear about it. There s even a share your story function under real stories on the website that makes it super easy. Please share this via your social media channels too as these stories are invaluable in helping bring DCE to life. Diane Primrose Marketing Manager - Healthier The Scottish Government CANCER TEAM CONTACT DETAILS cancerdeliveryteam@scotland.gsi.gov.uk CANCER. DON T GET SCARED, GET CHECKED.