A new cancer strategy involving a “radical” shake-up in public health prevention and the upgrading of outdated equipment could save 30,000 lives a year, according to its proponents.
A report by the Independent Cancer Taskforce has suggested six “strategic priorities” for the NHS to make “substantial improvements” in cancer care in England at a time when cancer cases are rising.
It said 280,000 people were diagnosed with cancer in England in 2013/14 and this was expected to reach more than 300,000 by 2020, and more than 360,000 by 2030.
One in two people will develop cancer at some point in their lives.
The taskforce, which was set up by NHS England in January to develop the next cancer strategy, said that with survival rates also increasing each year more and more people were living with cancer.
The report sets out proposals for how patient experience can be transformed both during and after treatment at a time when NHS cancer services are under unprecedented pressure.
With more than four in 10 cases of cancer caused by aspects of people’s lifestyles that they have the ability to change, the report said the figures showing that nearly one in five adults still smokes and a third drink too much alcohol were “stark”.
Tobacco remains the main risk factor for cancer, followed by obesity, and it said the government must come up with a new tobacco control strategy within the next 12 months, along with a national action plan on obesity.
It also wants to see a reduction in smoking from the current 18.4% to less than 13% by 2020.
The taskforce said investments must be made in up-to-date and effective equipment and treatments.
“Financial pressures in hospitals are precluding Linacs [radiotherapy machines] being replaced or updated in a timely way,” it said. “It is not in the interests of patients or cost-effective that we allow this situation to persist.”
It said radiotherapy was second only to surgery in its effectiveness in treating cancer but while 38% of cancer patients in England currently had radiotherapy as part of their treatment, international benchmarks suggested this should be closer to 50%.
It also calls for a “permanent and sustainable” model for the Cancer Drugs Fund, which has helped more than 72,000 cancer patients in England access the drugs their doctors think they need in the absence of official approval.
It said that while in recent years a number of immunotherapy drugs have been developed, which are showing “significant promise”, adoption of these therapies within the NHS will have to be handled carefully as they have a different profile of toxicities and side-effects to many of the treatments currently in use.
The report also sets out a national target for 95% of patients referred for testing by a GP to be definitively diagnosed with cancer or have it ruled out within four weeks.
It said this would require a “significant increase in diagnostic capacity”, but could also reduce the burden and reliance on GPs. Currently, patients urgently referred for suspected cancer by their GP need to be seen by a specialist within 14 days of referral, but no guidance exists for when patients can expect to get the results.
The strategy recommends giving all consenting patients electronic access to all test results and other communications involving further care by 2020, while it also wants to see a transformation in support for people living with and beyond cancer, with every patient having access to a “recovery package”.
Taskforce chairman Harpal Kumar said: “We have an opportunity to save many thousands of lives from cancer every year. We’re better informed than ever about how best to prevent, diagnose and treat the disease, and how to deliver better patient experience and quality of life. What’s needed now is action.
“Three previous cancer strategies did a great job of setting England on the path to a world-class cancer service. But we are a long way from where we should be. Our expectation is that the government and NHS will now make the investments required and implement this strategy with commitment and speed.”
Simon Stevens, chief executive of NHS England, said: “One in two of us will get cancer at some point in our lives, and the good news is that survival rates are their highest ever. But two-fifths of cancers are preventable, and half of patients are currently diagnosed when their cancers are advanced.
“That’s why the NHS will be backing this groundbreaking route map for prevention, earlier diagnosis, modern treatments and compassionate care, which the taskforce estimates could save 30,000 lives a year.”
Dr Richard Roope, Cancer Research UK’s GP expert, said: “The health system is about to face the ‘perfect storm’ – an ageing and growing population and worsening lifestyles. But we now have an unprecedented opportunity to change society’s attitudes and experience of cancer and ultimately improve survival. Earlier diagnosis and earlier treatment are key for this to happen.
“But if both the NHS and the public at large don’t seize this moment and change, we’ll be overwhelmed in the coming years with more people being diagnosed with more cancers, and diagnosed too late.”