Dr Paul Baughan GP, Dollar Health Centre, Clackmannanshire Clinical Lead, WoSCAN Primary Care Group

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Dr Paul Baughan GP, Dollar Health Centre,
ClackmannanshireClinical Lead, WoSCAN Primary
Care Group

• Mens Health and Cancer
• 4th December 2009

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Mens health and cancer

• Cancer in Scotland today
• Role of West of Scotland Cancer Network (WoSCAN)
• Specific projects relating to Mens Health and
  cancer within WoSCAN

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Lifetime risk of cancer in Scotland

• 1 in 3 men in Scotland will develop some form of
  cancer during their lifetime.
• For males, the lifetime risk of developing
• - lung cancer is estimated as 1 in 13
• - prostate cancer is 1 in 13
• - colorectal cancer is 1 in 18 men

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Figure 1 Ten most commonly diagnosed cancers in
males, 2006
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Scotland Number of new cancers and rate
per 100 000 by gender in 2006
Figure 5 Number of registrations and
age-specific rates per 100,000, all malignant
neoplasm's diagnosed in 2006, by sex
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Survival from cancer in Scotland
Survival is worst in patients with cancers that
often present at an advanced stage and are less
amenable to treatment (for example, cancers of
the lung and pancreas). Survival tends to be
better for - cancers for which patients
present at an early stage (for example,
malignant melanoma of the skin), - cancers
which can be detected early by screening (for
example, breast cancer) - cancers for which
there have been major advances in treatment (for
example, testicular cancer and leukaemias).
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Survival from cancer in Scotland
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Prevalence of cancer

• Over all ages, 2.2 of men in Scotland are living
  with cancer
• The prevalence of cancer in the Scottish
  population increases with age, with 10 of men
  aged 65 and over living with cancer

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Cancer in men in Scotland

• Incidence is higher
• Survival rates are lower
• Prevalence is higher

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Mens health and cancer

• Cancer in Scotland today
• Role of West of Scotland Cancer Network (WoSCAN)
• Specific projects relating to Mens Health and
  cancer within WoSCAN

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What is a network?
An extended group of people with similar
interests or concerns who interact and remain in
informal contact for mutual assistance or support
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What is a managed clinical network?
"linked groups of health professionals and
organisations from primary, secondary and
tertiary care, working in a co-ordinated manner,
unconstrained by existing professional and Health
Board boundaries, to ensure equitable provision
of high quality clinically effective services
throughout Scotland".
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West of Scotland Cancer Network (WoSCAN)
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West of Scotland Cancer Network
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West of Scotland Cancer Network
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West of Scotland Cancer Network
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West of Scotland Cancer Network
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Mens health and cancer

• Cancer in Scotland today
• Role of West of Scotland Cancer Network (WoSCAN)
• Specific projects relating to Mens Health and
  cancer within WoSCAN

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Specific projects relating to Mens Health and
cancer within WoSCAN

• Bowel screening
• Early presentation of men with cancer
• Referral to secondary care
• Complications of cancer

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Bowel Screening programme

• - Women AND MEN aged 50-74
• Started Ayrshire and Arran Sept 07
• Greater Glasgow and Clyde April 09

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Bowel Screening programme
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Colorectal screening uptake in Clackmannanshire
08-09
Number invited 12 682 women, 11 905 men
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- Gathering opinion and experiences from general
population about bowel screening programme,
including the helpfulness of patient literature
and ways to improve uptake.
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Specific projects relating to Mens Health and
cancer within WoSCAN

• Bowel screening
• Early presentation of men with cancer
• Referral to secondary care
• Complications of cancer

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The Patient Pathway?
lt62 days for 95 of urgent referrals
Commence Treatment
Urgent GP Referral
Assessment And Diagnosis
MDT meeting
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Patient notices symptoms
The real Patient Pathway
Patient reports symptoms
?
GP decides to refer
lt62 days for 95 of urgent referrals
Commence Treatment
Urgent GP Referral
Assessment And Diagnosis
MDT meeting
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Early diagnosis audit of cancer

• GPs asked to review notes of every patient
  diagnosed with cancer during 2007
• Note when patient initially spotted symptoms,
  when they first reported them to GP or nurse and
  when they were referred to secondary care
• Comment on ways to improve the pathway

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81 GP practices took part. 10 286 cancers
identified
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Time from symptoms to presentation
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Time from presentation to referral
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Gender differences
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Specific projects relating to Mens Health and
cancer within WoSCAN

• Bowel screening
• Early presentation of men with cancer
• Referral to secondary care
• Complications of cancer

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• Examined all Urgent suspected cancer referrals
  by GPs over a six month period across West of
  Scotland

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Numbers of urgent referrals per 1000 population
n 1400
n 2074
n 5692
n 2537
n 11703
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Number of urgent referrals per 1000 population by
tumour type
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Proportion of urgent referrals where same cancer
diagnosed as suspected
n 1400
n 2074
n 5692
n 2537
n 11703
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Proportion of urgent referrals where same cancer
diagnosed by tumour type
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Proportion of urgent referrals where urgent
referral complied with guidelines by tumour type
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Specific projects relating to Mens Health and
cancer within WoSCAN

• Bowel screening
• Early presentation of men with cancer
• Referral to secondary care
• Complications of cancer

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Safe management of cancer complications and
emergencies
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Summary

• Cancer in Scotland is important
• Men have poorer outcomes with cancer
• WoSCAN working on number of initiatives to
  understand and improve care that men with cancer
  receive

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• How do we engage with men better?

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paul.baughan_at_nhs.net