Screening and earlier diagnosis

We are working with a number of partners across South East London to improve uptake in cancer screening programmes and to reduce inequalities across the three screening programmes:

• Bowel
• Breast
• Cervical

We are carrying out a number of projects to support recovery and increase uptake in the screening programmes. If you would like to know what you can do in your local practice or area, then please contact us.  

The Cancer Alliance is working with primary care cancer leads across South East London to ensure that Primary Care Networks (PCNS) and GPs within these are kept up to date with changes and updates to pathways by:

• Developing primary care referral algorithms of changes to tumour specific pathways;  
• Developing an educational plan to support PCNs in delivering the early diagnosis elements of NHS England’s Direct Enhanced Scheme, a support guide (click here for guide) has been; developed and a series of webinars have taken place to support primary care;
• Piloting C the Signs in Bexley; 
• Producing a dedicated primary care lung cancer work programme due to the impact COVID-19 has had on lung cancer referrals;  
• Work with the charity Live Through This to improve the awareness of cancer risk and management in the LGBTQ+ population across Primary Care.

South East London Cancer Alliance, in partnership with the Borough GP Cancer Leads are pleased to share the Early Cancer Diagnosis PCN DES Support Guide.

This interactive support guide provides PCNs with practical steps to support them in delivering the Early Cancer Diagnosis elements of the PCN DES. The guide also includes links to support and educational guidance for primary care.

We encourage PCNs to download the document to their local IT systems and discuss the content at PCN roundtables and meetings.

The support guide and the content within this will be discussed at the upcoming PCN DES workshop which is being held on 16th June.

If you have any comments regarding the PCN DES Support Guide or would like to find out more about the PCN DES workshop then please use the content button at the top of the website to get in touch with the Cancer Alliance.

Download the guide as  PDF here.

King’s College Hospital at Denmark Hill has launched a new pilot to speed up lung cancer diagnosis. The implementation of direct to CT access can achieve a quicker diagnosis for people that have had a normal chest X-ray but still present with symptoms in line with NICE 12 guidelines. This will not only provide reassurance to the person but to the referring clinician also.

GPs can now refer patients aged over 40 years of age who meet the following criteria:

• eGFR in last 3-months.
• Normal recent chest X-ray undertaken that does not demonstrate lung cancer within last 3 months.
• Respiratory symptoms and GP suspicion for Lung Cancer.

This guide explains how General Practitioners, administrative staff, radiologists, radiologists, and chest clinic physicians can refer high risk, symptomatic patients.

SELCA is encouraging GPs in Primary Care within south east London to undertake opportunistic PSA testing on patients with a prostate who are a) aged 45 and over, and b) have either/both:
• A clear family history of prostate cancer
• Black / Caribbean ethnicity

Find out more here.

The Suspected Prostate Cancer Pathway has been one of the slowest to recover following the COVID-19 pandemic.

It is anticipated that there are 14,000 men in England with prostate cancer that have not been identified as a result and over 300 men in SEL.

GP Cancer Leads in South East London have developed the a template initiative for PCNs to identify men at a higher risk of having prostate cancer, using searches and a florey developed specifically for the initiative. The 4^th Service Requirement of the PCN DES aims to support identification of these men; “Focusing on prostate cancer, and informed by data provided by the local Cancer Alliance, develop and implement a plan to increase the proactive and opportunistic assessment of patients for a potential cancer diagnosis in population cohorts where referral rates have not recovered to their pre-pandemic baseline.”

The South East Cancer Alliance recommends that PCNs focus on men who are most at risk (target cohort): 

• those with a family history of prostate cancer aged over 45

• black men aged over 45

Prostate Cancer UK have developed an online risk checker which enables men between 45-70 years of age to assess their risk and also provides them with information to help them make an informed choice about whether to have a PSA test or not.  The link to this can be added to an AccuRx text so the patients can request a PSA test without having to book an appointment.

If you are interested in taking part in the pilot, then please contact estherappleby@nhs.net and you will be sent the prostate cancer risk checker link. 

Please find full instructions on how to complete the intervention here. The searches which are used to monitor impact (and therefore completing any DES fulfilment template) can also be downloaded on the following links, ‘text sent and PSA done’ and ‘text sent and 2ww referral made.’

Please Note:

There are searches for men at high risk of Prostate Cancer in EMIS as part of Ardens that could be used in conjunction with this. However, they include men over >70 years of age. We would therefore recommend that the list of patients generated by any search is reviewed by a clinician prior to texts being sent to ensure only suitable patients are contacted. It would not usually be recommended to offer a PSA test to a man with a life expectancy with less than 10 years.