Hereford and Worcester Sub Regional Trainers’ Workshop The Holiday Inn, Kidderminster Road

1. Hereford and Worcester Sub Regional Trainers’ Workshop The Holiday Inn, Kidderminster Road Bromsgrove, B61 9AB 9th November 2017 Dr Richard Roope RCGP and Cancer Research UK Cancer Clinical Champion Senior Clinical Advisor Cancer Research UK

2. Trainers’ Workshop • Earlier Diagnosis of Cancer

3. Trainers’ Workshop • Earlier Diagnosis of Cancer • Cancer: why all the interest? • Why is it important? • How have we done? • How could we do even better?

4. Cancer: why all the interest? Trainers’ Workshop

5. Cancer: why all the interest? Trainers’ Workshop Causes of death <75 4 Cancer Circulatory Disease Other Respiratory Liver 1 Circulatory Disease Cancer Liver Respiratory Other 2 Cancer Other Circulatory Disease Liver Respiratory 3 Circulatory Disease Cancer Respiratory Liver Other

6. Cancer: why all the interest? Trainers’ Workshop Causes of death <75 4 Cancer Circulatory Disease Other Respiratory Liver 1 Circulatory Disease Cancer Liver Respiratory Other 2 Cancer Other Circulatory Disease Liver Respiratory 3 Circulatory Disease Cancer Respiratory Liver Other Which do you think is the correct column? (high to low)

7. Cancer: why all the interest? Trainers’ Workshop Causes of death <75 4 Cancer Circulatory Disease Other Respiratory Liver 1 Circulatory Disease Cancer Liver Respiratory Other 2 Cancer Other Circulatory Disease Liver Respiratory 3 Circulatory Disease Cancer Respiratory Liver Other

8. Cancer: why all the interest? Trainers’ Workshop https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/307703/LW4L.pdf (last accessed 17.6.17)

9. Cancer: why all the interest? Trainers’ Workshop 37% https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/307703/LW4L.pdf (last accessed 17.6.17)

10. Cancer: why all the interest? Trainers’ Workshop https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/307703/LW4L.pdf (last accessed 17.6.17)

11. Trainers’ Workshop Cancer – why is it important? The Future:

12. Trainers’ Workshop Cancer – why is it important?

13. Trainers’ Workshop The perfect storm:

14. Trainers’ Workshop The perfect storm:

15. Trainers’ Workshop The Scale of the Challenge: The perfect storm…

16. Trainers’ Workshop The Scale of the Challenge: The perfect storm… Aging population

17. Trainers’ Workshop Aging Population

18. Trainers’ Workshop Aging Population

19. Trainers’ Workshop Aging Population - Centenarians http://www.ons.gov.uk/ons/rel/lifetables/historic-and-projected-data-from-the-period-and-cohort-life-tables/2012-based/info-surviving-to-age-100.html last accessed 3.11.17 http://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/ageing/bulletins/estimatesoftheveryoldincludingcentenarians/2002to2015last accessed 3.11.17

20. Trainers’ Workshop The Scale of the Challenge: • The perfect storm… • Aging population • Lifestyles less healthy: • Smoking • Diet • Alcohol • Exercise • Sun exposure

21. Trainers’ Workshop The Scale of the Challenge: • The perfect storm… • Aging population • Lifestyles less healthy: • Smoking • Diet • Alcohol • Exercise • Sun exposure Increasing survival

22. Trainers’ Workshop The perfect storm: Numbers of cancers http://globocan.iarc.fr/old/burden.asp?selection_pop=206826&Text-p=United+Kingdom&selection_cancer=290&Text-c=All+cancers+excl.+non-melanoma+skin+cancer&pYear=18&type=0&window=1&submit=%C2%A0Execute https://publications.cancerresearchuk.org/downloads/product/CS_REPORT_WORLD.pdf

23. Trainers’ Workshop The Scale of the Challenge: By the end of 2016, there were 1,000 people in the UK being diagnosed with cancer every day Mistry, M., et al., Cancer incidence in the United Kingdom: projections to the year 2030. Br J Cancer, 2011. 105: p. 17951803.

24. Cancer: why all the interest? Trainers’ Workshop 1 in 2 people will be diagnosed with one or more cancers in their lifetime

25. Lifetime risk of cancer: Trainers’ Workshop http://www.cancerresearchuk.org/cancer-info/cancerstats/incidence/risk/

26. Cancer: why all the interest? Trainers’ Workshop 1 in 2 people will be diagnosed with one or more cancers in their lifetime 10 year survival has improved to reach 50%

27. Cancer: why all the interest? Trainers’ Workshop 1 in 2 people will be diagnosed with one or more cancers in their lifetime 10 year survival has improved to reach 50% www.cancerresearchuk.org/health-professional/cancer-statistics/survival/all-cancers-combined#heading-One– last accessed 3.11.17

28. Cancer: why all the interest? Trainers’ Workshop 1 in 2 people will be diagnosed with one or more cancers in their lifetime 10 year survival has improved to reach 50%, but… Cancer survival in the UK still lags behind comparable health economies

29. Hasn’t cancer had its turn? Trainers’ Workshop

30. Hasn’t cancer had its turn? Trainers’ Workshop Cancer receives what proportion of NHS spend? • 2.4% • 5.4% • 8.4% • 11.4% • 14.4% Discuss with your neighbour….

31. Hasn’t cancer had its turn? • Total NHS spend in 2012/3: £125,700,000,000 Trainers’ Workshop

32. Hasn’t cancer had its turn? • Total NHS spend in 2012/3: £125,700,000,000 • Total NHS spend in 2012/3: £2008 per head Trainers’ Workshop

33. Hasn’t cancer had its turn? • Total NHS spend in 2012/3: £125,700,000,000 • Total NHS spend in 2012/3: £2008 per head • Total NHS spend cancer care: £109 per head Trainers’ Workshop

34. Hasn’t cancer had its turn? • Total NHS spend in 2012/3: £125,700,000,000 • Total NHS spend in 2012/3: £2008 per head • Total NHS spend cancer care: £109 per head • Just 5.4% of NHS spend Trainers’ Workshop http://www.nuffieldtrust.org.uk/nhs-numbers-0last accessed 1.3.17

35. Hasn’t cancer had its turn? Trainers’ Workshop Cancer receives what proportion of NHS spend? • 2.4% • 5.4% • 8.4% • 11.4% • 14.4%

36. Why is early diagnosis important? Trainers’ Workshop

37. Why is early diagnosis important? Trainers’ Workshop http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/breast-cancer/survival#heading-Three (last accessed 3.11.17)

38. Why is early diagnosis important? Trainers’ Workshop

39. Why is early diagnosis important? Trainers’ Workshop http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/prostate-cancer/survival#heading-Two (last accessed 3.11.17)

40. Why is early diagnosis important? Trainers’ Workshop

41. Why is early diagnosis important? Trainers’ Workshop http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/bowel-cancer/survival#heading-Three (last accessed 3.11.17)

42. Why is early diagnosis important? Trainers’ Workshop

43. Why is early diagnosis important? Trainers’ Workshop http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/lung-cancer/survival#heading-Three (last accessed 3.11.17)

44. Why is early diagnosis important? Trainers’ Workshop

45. Why is early diagnosis important? Trainers’ Workshop All Cancers www.cancerresearchuk.org/health-professional/cancer-statistics/incidence/all-cancers-combined#heading-Two (last accessed 3.11.17)

46. Why is early diagnosis important? Trainers’ Workshop All Cancers Stage Shift www.cancerresearchuk.org/health-professional/cancer-statistics/incidence/all-cancers-combined#heading-Two (last accessed 3.11.17)

47. Minimum increased 5 year survival with 10% increase in stages 1 & 2 Trainers’ Workshop https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/388160/fourth_annual_report.pdf (last accessed 3.11.17)

48. Why is early diagnosis important? • Cost Trainers’ Workshop

49. Why is early diagnosis important? Trainers’ Workshop http://www.cancerresearchuk.org/sites/default/files/saving_lives_averting_costs.pdf

50. Why is early diagnosis important? Trainers’ Workshop ↓72.8% ↓62.7% ↓64.9% ↓38.9% http://www.cancerresearchuk.org/sites/default/files/saving_lives_averting_costs.pdf