25 Oct 2021
At a recent Health and Social Care Committee hearing early detection was highlighted as being one of the main reasons why cancer detection rates lag those of countries such as Australia and Denmark.
Cancer survival is one of the key indicators of how good cancer services are in terms of detection, rapid and effective diagnosis, and treatment. Improving survival rates will help close the gap between our health system and other countries. Cancer Research highlights its ambition that three in four people will survive cancer by 2034.
Technology and innovation provide the basis for significant leaps in cancer treatments, with more precise and personalised medicines becoming available and there is still more that can be done in terms of early diagnosis.
The NHS has an ambition to increase the number of people diagnosed in the early stages (one and two) from around 55 per cent to 75 per cent by 2028. However, to reach this goal, change is needed across the whole system. For instance, if we encourage people with signs and symptoms to contact their local health services, good referral systems need to be in place. We also need to shorten the time for tests and diagnosis with a greater capacity to carry out imaging investigations and diagnostic tests.
We can also make improvements in the way we use data in the detection and prevention of cancer. In Australia, the use of data was a key factor in leading the way in cancer detection and improving survival rates.
The Australian Government passed legislation in 2016 to introduce a National Cancer Screening Register (NCSR), a world class population health platform developed to support the Australian Government’s National Cervical Screening Program and National Bowel Cancer Screening Program .
The Australian Government identified a clear need for a national contemporary electronic infrastructure to adhere to nationally consistent clinical guidelines, data reporting and coding and to create 1 national record for each individual participating in the programmes.
Following the migration and merging of datasets from 8 legacy State and Territory cervical screening registers, and the legacy bowel cancer screening register, the NCSR links the participant records to a national government dataset, using complex clinical algorithms to identify eligible Australians. This equips the NCSR with the necessary information needed to target invitations, recalls, follow up and test kits to maximise early cancer detection and prevention to ensure Australia remains a world leader through innovation.
In addition to supporting the operational aspects of the programmes, the NCSR was developed to progress the transition to five-yearly HPV testing and self-sampling for cervical screening, as well as providing real-time data reporting to screening programme providers to inform policy and improve quality.
The platform is clinically led, standards-based and architecturally driven. It was developed by bringing together experienced teams in areas including epidemiology, clinical guidelines digitisation, screening pathway design, health informatics, clinical systems integration and healthcare stakeholder engagement to work collaboratively with health technology experts.
It is the only proven end-to-end national population health service to support multiple cancer screening programmes. In addition, it is scalable for future population health initiatives such as breast and lung cancer screening and is fully operational to support the 25 million Australian population.
The results are world leading outcomes. Australia is now on track to be the first to eliminate cervical cancer as a public health problem by 2035 through HPV testing, HPV vaccination and the NCSR platform. It’s clear from the Australian example that bringing together data in this way can help facilitate improved detection and therefore cancer survival rates and that the UK would benefit greatly from following this model to improve screening opportunities.