Recovery and redesign: cancer services - action plan

In response to the pandemic, we have adapted to new circumstances in which cancer services continue to operate. The plan details actions that will both redesign cancer services to benefit patients, and increase our services’ overall resilience to future rises in COVID-19 prevalence.

A Focus On Lung Cancer

Lung cancer remains Scotland’s most common cancer and is predicted to continue to be so over 2023-2027. Public Health Scotland has predicted lung cancer to increase by 29% for women and 12% for men between 2008-2012 and 2023-2027.[2] Since the Detect Cancer Early (DCE) Programme started in 2012, the proportion of lung cancer diagnoses at the earliest stage have gone up overall by 36%, and specifically by 38% in the most deprived areas[3].

Over the pandemic, the number of urgent suspicion of lung cancer (USC) referrals into secondary care reduced dramatically. Given the overlap of symptoms between COVID-19 and lung cancer (cough, breathlessness and fatigue) this tumour group requires specific attention to ensure work to date to improve early diagnosis rates isn’t reversed. While USC lung referrals have seen a steady increase since the height of the pandemic, they remain below pre-COVID levels, with concern these may lead to an increase in late presentation, morbidity, and mortality.

We will therefore deploy specific actions to address this:

28. Our £44 million Detect Cancer Early Programme will continue to support our aim to increase the proportion of Scotland’s most common cancers (bowel, breast and lung) detected early. An additional £500,000 will be invested in developing a lung cancer awareness campaign that will launch in 2021 to highlight the importance of early detection and prompt people with potential symptoms to seek help as early as possible. Stakeholder engagement will be key to delivering this activity, including the Scottish Cancer Coalition and Less Survivable Cancer Taskforce to ensure patient opinions are fed into the process.

29. Clinical guidance on the management of urgent suspicion of lung cancer referrals during COVID-19 was published in July 2020 and will be kept under review, with support from the Scottish Primary Care Cancer Group. The development of additional primary care guidance may be required in the future, depending on emerging referral trends and primary care challenges.

30. We will appraise the options, opportunities, harms and benefits of targeted lung health checks in Scotland. This will begin with an exploratory piece of research by The University of Edinburgh to understand the feasibility of the introduction of lung health checks within Scotland.

31. The impact and effectiveness of one-stop lung clinics, for new USC patients, will be monitored where already underway in NHS Scotland, to ensure best practice is rolled out across Scotland.

Table 3: Timeline for completion of lung cancer actions
Description below

The graphic shows a timeline, displaying the end of each quarter and running from December 2020 to March 2023, and the expected completion times for action points 28 to 31, as described above. It shows that action point 28 will start after December 2020 and be completed by end of March 2021. Action point 29 will be completed by March 2023. Action point 30 will be completed by December 2021. Finally, it shows action point 31 will be done every 6 months, starting in March 2021 through to the end of the plan in March 2023.



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