Surveillance and case finding
Surveillance of particular patients who are at higher of developing cancer due to genetics or other factors is a route to early diagnosis and increased survival. Working with primary and secondary care and genetics centres, the Cancer Alliance has initiated and supported some important surveillance projects.
Through community health checks and screening services, we identify eligible individuals and follow-up with them to ensure they receive the care they need to enable early identification of cancer, if it develops.
Case finding is a way to actively seek people who may have a particular cancer but who are yet diagnosed. If identified they may benefit from early detection and treatment. It means looking for cases, rather than waiting for people to visit their GP or A&E with symptoms.
Lynch Syndrome
We deliver the North Central London Lynch Surveillance Hub at UCLH. We are seeking to secure ongoing commissioning of the service, to ensure a fully funded continuing service.
The Hub provides lifelong follow-up care to people with Lynch Syndrome who are at higher risk, in particular, of bowel, endometrial and ovarian cancers, due to this genetic condition.
Liver surveillance
We are working with liver teams in local hospitals to transform liver surveillance services.
Trusts are making changes to their IT processes, to ensure people eligible for surveillance are easily identified, enrolled, tracked and supported to attend necessary follow-up appointments. The services also work closely with the Community Liver Health Checks programme (delivered by Royal Free London) to enrol eligible patients from the programme into liver surveillance.
Ovarian cancer surveillance
Using the Risk of Ovarian Cancer Algorithm (ROCA) test, women at high risk of ovarian cancer, due to BRCA1 or BRCA2 gene alteration, can be offered surveillance at UCLH. This is the first service of its kind for ovarian cancer to be available in the UK. Research and set up of the service has been supported by the Cancer Alliance.
Pancreatic cancer surveillance and case finding
North Central London is one of 10 areas to pilot pancreatic cancer case finding in primary care, involving five primary care networks (PCNs). This is an NHS England initiative to enhance early detection in primary care settings. GP patient records will be used to find and check people aged 60 and over who have new onset diabetes and unexplained weight loss. These conditions can provide early indications of the disease.
Pancreatic cancer is the 10th most common cancer in the UK and the fifth leading cause of cancer death in England. It accounts for 3% of all cancer diagnoses, but survival rates are low. Only 7.3% of patients live beyond five years after their diagnosis. Research suggests that case-finding programmes could lead to a 2.6% to 4.7% improvement in the diagnosis of pancreatic cancer at earlier, more treatable stages.
COMPASS
The COMPASS (Community Pharmacy Assessment for Barrett’s Oesophagus and Reflux Symptoms) project aims to use capsule sponge tests to identify undiagnosed patients with Barrett’s oesophagus and early-stage oesophageal adenocarcinoma.
A key part of the project is to identify patients in community pharmacy settings and establish referral routes into community-based clinics for testing.
