Screening, Prevention and Early Diagnosis. Dr Kate Brain Division of Population Medicine Cardiff University

Transcription

1 Screening, Prevention and Early Diagnosis Dr Kate Brain Division of Population Medicine Cardiff University

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3 Focus on significant public health problems and inequalities in Wales Continue strong work in cancer Improve understanding of delayed symptom diagnosis and non participation in screening, particularly in high risk/harder to reach groups Develop and test person-centred strategies to increase public awareness of cancer improve equitable uptake of screening (bowel, lung) accelerate early diagnosis reduce harm from tobacco Our Aims Build strong academic, clinical and community partnerships

4 % anticipating >2 weeks before help-seeking % correctly recognise symptom Cancer awareness and delay Symptom awareness Patient delay in the in the UK UK Persistent cough Unexplained bleeding Unexplained lump Persistent cough Rectal bleeding Breast changes Quaife S, Forbes L, Ramirez A, Brain KE, Donnelly C, Simon AE, Wardle J. Recognition of cancer warning signs and anticipated delay in help-seeking in a population sample of adults in the UK. Brit J Cancer 2014; 110: 12-8.

5 Beliefs and barriers to early symptom presentation Well a lot of people with cancer would rather die from the cancer than go through the treatment I clams up [when I go to the doctor] [my wife would] do all the talking I m not a very good talker she s a better talker than me I think a lot of people they re afraid to go to the doctor s in case they actually say yes, you have got cancer...so a lot of them will just sort of put it off until they re so ill they ve got to go They don t pay you to go to the doctor I can t afford to lose time off work I ve got to wait for a bus, get down on the bus, and then go back to work which would take me an hour Phone the funeral director, I ve got cancer! When I go down [to the doctor] and she ll say I know you re not drinking, but how about smoking? and I say do you want me to cut my throat? McCutchan G, Wood F, Smits S, Edwards A, Brain K. Barriers to cancer symptom presentation among people from low socioeconomic groups. BMC Public Health 2016; 16: 1052.

6 Awareness and Beliefs About Cancer (ABACus) Health check development Feasibility study: - prospective questionnaires (awareness, beliefs, behaviour) - observations (fidelity) - interviews (acceptability, usage) Smits S, McCutchan G, Wood F, et al. Development of a behaviour change intervention to encourage timely cancer symptom presentation among people living in deprived communities using the Behaviour Change Wheel. Ann Behav Med (in press).

7 PRIFYSGOL BANGOR / BANGOR UNIVERSITY WICKED (Wales Interventions and Cancer Knowledge about Early Diagnosis) Develop and evaluate an intervention for GPs and their teams to achieve: prompter referral of suspected cancer earlier and cost-effective diagnosis of symptomatic cancer improved survival

8 Bowel Screening Home FOB test kit every two years for adults aged in England & Wales 70% 60% 50% 40% 30% 20% 10% Adapted technologies may be offered in future 0% Q1 - least deprived Q2 Q3 Q4 Q5 - most deprived Bowel screening uptake by deprivation quintile and gender,

9 EASR per 100,000 population Lung cancer early detection and prevention Effective lung cancer early detection strategies are essential: ELCID trial of enhanced chest x-ray UKLS trial of low dose CT screening LUSH study of lung symptom awareness Welsh lung cancer awareness campaign rolled out in 2016 Reducing fear, fatalism and stigma is key to engaging high risk groups Lung cancer incidence per deprivation quintile in Wales ( , WCISU) Deprivation quintile

10 Screening, Prevention and Early Diagnosis: Future Direction Embed behavioural research into clinical and biomedical cancer research Increase impact by translating research into patient/population benefit Whole person approach to engagement Increase capacity in SPED through multi-agency collaboration /