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

1. Dr Paul Baughan GP, Dollar Health Centre, ClackmannanshireClinical Lead, WoSCAN Primary Care Group Men’s Health and Cancer 4th December 2009

2. Men’s health and cancer Cancer in Scotland today Role of West of Scotland Cancer Network (WoSCAN) Specific projects relating to Men’s Health and cancer within WoSCAN

3. 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

4. Figure 1: Ten most commonly diagnosed cancers in males, 2006

5. 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

6. 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).

7. Survival from cancer in Scotland

8. 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

9. Cancer in men in Scotland • Incidence is higher • Survival rates are lower • Prevalence is higher

11. Men’s health and cancer Cancer in Scotland today Role of West of Scotland Cancer Network (WoSCAN) Specific projects relating to Men’s Health and cancer within WoSCAN

12. 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’

13. 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".

14. West of Scotland Cancer Network (WoSCAN)

15. West of Scotland Cancer Network

16. West of Scotland Cancer Network

17. West of Scotland Cancer Network

18. West of Scotland Cancer Network

19. Men’s health and cancer Cancer in Scotland today Role of West of Scotland Cancer Network (WoSCAN) Specific projects relating to Men’s Health and cancer within WoSCAN

20. Specific projects relating to Men’s Health and cancer within WoSCAN • Bowel screening • Early presentation of men with cancer • Referral to secondary care • Complications of cancer

21. Bowel Screening programme • - Women AND MEN aged 50-74 • Started Ayrshire and Arran Sept 07 • Greater Glasgow and Clyde April 09

22. Bowel Screening programme

23. Colorectal screening uptake in Clackmannanshire 08-09 Number invited: 12 682 women, 11 905 men

24. - Gathering opinion and experiences from general population about bowel screening programme, including the helpfulness of patient literature and ways to improve uptake.

25. Specific projects relating to Men’s Health and cancer within WoSCAN • Bowel screening • Early presentation of men with cancer • Referral to secondary care • Complications of cancer

26. The ‘Patient Pathway?’ <62 days for 95% of urgent referrals Urgent GP Referral Assessment And Diagnosis MDT meeting Commence Treatment

27. Patient notices symptoms The real ‘Patient Pathway’ Patient reports symptoms ? GP decides to refer <62 days for 95% of urgent referrals Urgent GP Referral Assessment And Diagnosis MDT meeting Commence Treatment

28. 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

29. 81% GP practices took part. 10 286 cancers identified

30. Time from symptoms to presentation

31. Time from presentation to referral

32. Gender differences

35. Specific projects relating to Men’s Health and cancer within WoSCAN • Bowel screening • Early presentation of men with cancer • Referral to secondary care • Complications of cancer

36. Examined all ‘Urgent suspected cancer’ referrals by GPs over a six month period across West of Scotland

37. Numbers of urgent referrals per 1000 population: n = 1400 n = 2074 n = 5692 n = 2537 n = 11703

38. Number of urgent referrals per 1000 population by tumour type:

39. Proportion of urgent referrals where same cancer diagnosed as suspected: n = 1400 n = 2074 n = 5692 n = 2537 n = 11703

40. Proportion of urgent referrals where same cancer diagnosed by tumour type:

41. Proportion of urgent referrals where urgent referral complied with guidelines by tumour type:

42. Specific projects relating to Men’s Health and cancer within WoSCAN • Bowel screening • Early presentation of men with cancer • Referral to secondary care • Complications of cancer

43. Safe management of cancer complications and emergencies

44. 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

45. How do we engage with men better?

47. paul.baughan@nhs.net