Offer cancer screenings during lunch breaks, report urges

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By Denis Campbell,  Health policy editor

NHS could tailor appointments so people don’t have to take time off work under proposals

People could be offered cancer screenings in their lunch breaks in a bid to reverse the alarming fall in those attending appointments, under plans being considered by NHS bosses.

Those invited for screening should be able to go in the evening or at weekends, to stop them having to take time off work, according to a major report ordered by ministers and the NHS.

The health service must kickstart a consumer revolution in how people access potentially life-saving tests as part of a package of “urgent action” to arrest a slide in the number of people who turn up to be screened, Prof Sir Mike Richards said.

Text messages and social media campaigns should also be used to encourage people to attend, the government’s former cancer tsar added.

And while GP surgeries and health centres should be used, other premises near where people live should also be pressed into service, he added.

Driving up participation is a priority for the NHS because take-up rates have fallen so dramatically in recent years. For example, just 71% of women in England turn up to their appointment to be screened for cervical cancer – the lowest proportion for 21 years – while a similarly low percentage undergo screenings for breast cancer.

Bowel cancer has the lowest take-up rate of all: just 58% of those invited come for their appointment.

Richards examined trends in screening attendance for those three cancers as well as diabetic eye disease and the risk of someone suffering an abdominal aortic aneurysm. Those two have higher attendance rates, of 82.7% and 80.5% respectively.

“Screening programmes are a vital way for the NHS to save more lives through prevention and earlier diagnosis and currently they save around 10,000 lives every year. That is something to be immensely proud of,” Richards said.

“Yet we know that they are far from realising their full potential. People live increasingly busy lives and we need to make it as easy and convenient as possible for people to attend these important appointments,” he added.

Screening programmes for a range of conditions collectively invite more than 15 million people a year to attend. But only about 10 million – two in three – turn up for the appointment.

The NHS in England has already started to do more to make screening easier for people to undergo by offering lung cancer checks in lorries in supermarket carparks.

GP practices in south-west London have found that ringing and sending letters to people who did not attend their bowel cancer screening appointment led to a 12% rise in take-up.

Similarly, messages posted on Facebook community groups have helped boost attendance at breast cancer screening appointments in Stoke-on-Trent by 13% since 2015.

Setting out detailed plans, Richards added: “The slow decline in the number of people who take up the offer of screening out of those eligible … [which is] particularly evident in the breast and cervical screening programmes … must be reversed.”

Cancer charities welcomed the likely overhaul of screening that will now follow. Lynda Thomas, chief executive of Macmillan Cancer Support, urged ministers to implement Richards’s recommendations in full. “At the heart of this issue are people and their families whose lives can be turned upside down by a cancer diagnosis. Screening and early detection can improve and even save their lives.”

Simon Stevens, the chief executive of NHS England, said getting more people to turn up would help it achieve its aim of saving 55,000 more people a year from dying of cancer by 2030, by improving early diagnosis.

“His sensible recommendations keep all that is good about NHS screening services while rightly setting out a blueprint for more convenient access, upgraded technology and progressively more tailored approaches to early diagnosis.”

Robert Music, chief executive of Jo’s Cervical Cancer Trust, said: “We have long been calling for more accessible appointments, with women able to book and attend screening at locations other than the GP they are registered with, and are pleased to see this referenced.”