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CANCER IN SCOTLAND: ACTION FOR CHANGE
03. DETECTING AND TREATING CANCER EARLY
"By identifying cancer very early in its development treatment can begin at a much earlier stage than might otherwise be the case."
Cervical Cancer
Some 400,000 women a year aged between 20 and 60 in Scotland will benefit from investment in a new cervical screening technique. Following a successful pilot, Liquid Based Cytology, an alternative method of smear taking, will be introduced into the Scottish Cervical Screening Programme by 2004. To assist with its introduction 2.75 million has been invested in the set-up and associated training costs.
It is expected that Liquid Based Cytology will reduce the rate of unsatisfactory smears and around 24,000 women each year will not need to be recalled for a repeat smear. In addition up to 3,600 women a year will no longer need to undergo colposcopy examination.
A Project Board is considering a new national cervical screening call-recall IT system which is expected to be introduced around late spring 2003.
Breast Cancer
From 2003-04 the upper age limit for routine invitation for the Scottish Breast Cancer Screening Programme will rise from 65 to 70 years and will be implemented over the 3-year round of screening. This means an extra 50,000 women will be routinely invited for breast screening each year - which represents an increase of 33%.
Colorectal Cancer
The Scottish arm of the UK Colorectal Screening Pilot in Fife, Grampian and Tayside will be continued for a second round of screening. A report on the evaluation of the pilot is expected in spring 2003.
Prostate Cancer
A report setting out options for the future management of prostate cancer in Scotland, including research, higher professional training and education and treatment was prepared by a group on behalf of the previous Scottish Cancer Group. This was circulated to Regional Cancer Advisory Groups (RCAGs) in June 2002 with a request to review and report on how they propose to take these services forward.
The value of routine Prostate Specific Antigen (PSA) testing as a method of population screening remains uncertain and controversial. In December last year the Scottish Executive advised that men who ask their GP for a PSA test should have one and any follow-up necessary, from the NHS. This must be accompanied by full information on the reliability of the test itself and of the problems and side effects of further diagnostic procedures and treatment. The Department of Health (DH) Prostate Cancer Risk Management Programme (PCRMP) have developed a Primary Care resource pack that is generally agreed to be as relevant and useful to primary care teams in Scotland as it is in England. The resource pack, aimed at primary care clinicians advising and counselling asymptomatic men, is being circulated to every GP in Scotland.
Oral Cancers
The Scottish Intercollegiate Guidelines Network (SIGN) plan to begin development of a head/neck/oral cancer guideline in October 2002.
An Implementation Sub Group on Oral Health of the Elderly has been set up to take forward the commitment to improve preventive services for the elderly contained within the
Action Plan for Dental Services in Scotland and will produce a draft report by 2002.
Genetic Screening
A pilot audit has now been completed to evaluate the effectiveness of processes and outcomes in terms of the clinical and cost-effectiveness of the Cancer Genetics services established with 250k dedicated funding for genetic counsellors in 1999. It is hoped to commence routine prospective audit during 2003.
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