All.Can Roundup # 1
Cancer prevention in all policies
- Central cancer prevention strategy must involve creating an environment – through regulation, education and support programmes – that encourages individuals to adopt healthy behaviours.
- Governmental responsibility extends beyond the function of traditional health-focused departments; agencies involved in environmental protection, occupational safety and transportation also have a role in cancer prevention.
- Cancer prevention and health promotion are also in the realm of the zoning board, the board of education, and the board of health.
The science of precision prevention of cancer
- ‘Precision prevention’ could give the false impression of a curative or preventive power that is absent when transferred into practice. Availability of the tools should not be confused with achievement of the goal.
- Application of precision to prevention can be very complex, including identification of individuals who might benefit. The number-needed-to-treat (NNT) might be quite high, having an impact on cost-effectiveness.
- There is a risk that the much-needed shift to redress the imbalance between cancer prevention and treatment may be replaced by a search for a medical solution for all impending ills, combined with a resulting imbalance between the emphasis on the population and high-risk groups.
Burden and centralised treatment in Europe of rare tumours: results of RARECAREnet—a population-based study
- Survival has increased for most rare cancers, with the largest increases for haematological tumours and sarcomas.
- The amount of centralisation of rare cancer treatment varied widely between cancers and between countries. The Netherlands and Slovenia had the highest treatment volumes.
- Survival could be improved by early diagnosis, new treatments, and improved case management. The centralisation of treatment could be improved in the seven European countries studied.
Developing a model for Integrated Care in Prostate Cancer (ICARE-P)
- Prostate cancer requires innovative approaches of care delivery, strengthening collaboration and interoperability, linking the patient and the healthcare team.
- This was a two-phase study. Firstly, input from healthcare professionals and patients was used to refine the intervention. Secondly, a randomised controlled trial was conducted of an integrated follow-up care model using digital technology. In Phase 1, researchers developed an online adaptive prostate-specific Holistic Needs Assessment system, training for staff and qualitative interviews.
- The study found that men strongly supported the intervention, even if they had low digital literacy.
- Primary care clinicians endorsed the need for improved communication with specialists (highlighting their current frustration).
- The study demonstrated slow adoption of digital technology in secondary care compared with primary care. Barriers included concerns about data security and a lack of attention to the needs of end users.
Aggressive end-of life care may not improve survival time of women with metastatic breast cancer
- This study analysed factors associated with aggressive end-of-life care, and evaluated economic and survival time outcomes.
- Patients who lived more than 12 months after diagnosis were more likely to utilise hospices and less likely to receive aggressive end-of-life care.
- Patients with a shorter survival time had significantly higher costs of care per month alive, compared with patients with a longer survival time.
Policy and initiatives roundup
EU Horizon 2020
- A public consultation involving payers, academia, patient groups, industry, healthcare professionals etc. found that 87% supported EU cooperation on HTA.
- To date, Horizon 2020 devoted €652 million to cancer research, of which €120 million was for cancer prevention and early diagnosis. €99 million was awarded to cancer research performed by UK organisations as follows: academia (78%), small and medium-sized enterprises (13%), research organisations (6%), industry (3%) and other public organisations (0.05%).
UK Cancer Patient Experience survey: patients feel increasingly positive about their care
- 87.5% of patients in the National Cancer Patient Experience Survey 2016 said they had their cancer tests at the right time, up from 86.6% the previous year.
- 78% of respondents said that they were definitely involved as much as they wanted to be in decisions about their care.
NHS England launching plan to drive out wasteful and ineffective drug prescription
- The English health service has launched a consultation on new national guidelines stating that treatments including homeopathy and herbal treatments should generally not be prescribed.
- The consultation also covers 3,200 prescription items, many of which are available direct to the public through retail outlets and pharmacies at a far lower price than the cost to the NHS.
- It is estimated that ending prescription of these treatments would saving the NHS more than £190 million per year, which the service could then reinvest in more effective treatments.
- NHS England Medical Director Sir Bruce Keogh said: ‘We need to end unnecessary expense to give us a bigger therapeutic bang for the NHS buck.’