1. Early Diagnosis of Cancer Working with GP Practices in Islington

2. What comes into your head when you think about cancer?

3. Cancer in England More than 331,000 people were diagnosed with cancer in 2011 in the UK - that’s around 910 people every day Twice as many people survive cancer now compared with 40 years ago.

4. Cancer Survival If England’s cancer survival rates were the same as the European average, 5,000 lives would be saved every year and 10,000 if England was same as best in Europe. Diagnosis at a late stage is thought to be the single most important reason for lower survival rates in England.

5. Do you know what the most common cancers are?

6. Most common cancers in Islington The most common cancers in Islington are breast, lung, bowel and prostate. These are the four most common cancers in UK.

7. Cancer in Islington The rate of new cancer cases (for all cancer types) and cancer deaths is significantly higher in Islington than in London and England. This is largely because Islington has higher levels of deprivation, which is associated with: –risk factors for cancer, such as high smoking rates, increased alcohol consumption and higher levels of overweight and obesity, –lower awareness of cancer symptoms and national cancer screening programmes.

8. Cancer deaths in Islington Lung cancer is the biggest cause of cancer death, followed by bowel and breast cancer. Cancer is the biggest cause of premature death (under 75 years) in Islington and the second biggest cause of death overall. Total number of cancer deaths 2010/12 Source: ONS, 2012

9. Diagnosing cancer earlier saves lives Do you know how many people survive bowel cancer and breast cancer if it is diagnosed early?

10. Early diagnosis of bowel cancer shows 93% of those diagnosed survive 5 years or longer Late diagnosis of bowel cancer where the disease is advanced, less than 7% of those diagnosed will survive five years or longer In breast cancer early diagnosis results in 92% survival rate of five years or longer and people diagnosed with advance disease 15% surviving five years or longer. ©

11. Raise awareness of cancer symptoms Encourage people to go to their GP Raise awareness of the importance of screening Talk about cancer How can we help to diagnose cancer earlier?

12. So....what are the symptoms of cancer?

13. Why do some people delay going to the doctor with symptoms?

14. Barriers to seeing a GP

15. Cancer screening The number of people taking part in the national cancer screening programmes in Islington is lower than the London and England average and below the national targets. Source: NHS England, March 2013; Bowel screening, 2012/13

16. Myths & Beliefs ©

17. GP practices are important in early diagnosis To help improve early diagnosis: people need to go and see their doctor as soon as they notice unusual or persistent symptoms and doctors and patients need to have effective consultations so that important symptoms are discussed.

18. However.. Some people do not go to their GP with symptoms early enough. Some people are not aware of cancer symptoms, what causes cancer, role of screening. GPs will only see 7-8 new cancer cases in a year. Many cancer symptoms could also be symptoms of something else. GP appointments last around 10 minutes.

19. How can we tackle this?

20. YOU ©

21. What can your patient group do to help with early diagnosis? Raise awareness of cancer symptoms Prevention messages & promoting screening Encourage people to go to their GP Effective consultations

22. Raise awareness

24. SMOKIN G Prevention

26. Effective consultations GPs have limited time with patients and continuity of care is less common nowadays - patients often have a relationship with a practice rather than a doctor. Patients often wait to be prompted by the doctor before discussing certain symptoms. GPs often say that patients will wait until the end of the consultation to discuss their most serious or worrying symptoms. The less time a GP spends on clinical investigation means that they are less likely to gather enough meaningful information/consider possibility of cancer. This can result in GPs being less likely to spot changes in an individual; symptoms can be attributed to existing conditions and patients feel that they are not being listened to.

27. What could you do in your practice to make this better?

28. Tips for visiting your doctor Before the appointment Keep a symptom diary –write down what’s been happening, how long it’s been going on for, and how often it occurs. –Make sure you include everything even if you think it’s not serious or related (like if you’ve been feeling more tired or have lost weight). Take a notebook –Write down what you want to say –Make a list of questions/problems you want to discuss before the appointment.

29. Tips for visiting your doctor At the practice Provide a ‘consultation’ sheet for patients to fill in while waiting to see the GP. This could include things like: –What you want to talk to the doctor about –How long you have had symptoms During the consultation Be direct. If you have a problem that you find embarrassing or difficult to talk about, don’t leave it to the end of the appointment before mentioning it. Remember your problem is likely to be a common one for your GP, who is there to help you. Don’t be afraid to say if you don’t understand something your doctor has said.

30. We are happy to help if you want to discuss anything further. There is a pack for each practice with leaflets and posters. Thank you for inviting us to your meeting. Contact details: Anne-Marie LoveGwen Kaplan Senior Primary Care Facilitator Cancer Awareness Lead Trainer for Cancer – IslingtonCancer Research UK Email: anne-marie.love@cancer.org.ukgwen.kaplan@cancer.org.ukanne-marie.love@cancer.org.ukgwen.kaplan@cancer.org.uk Mobile: 07918721709