Transcript Screening and having Lifestyle Conversations

Camden & Islington
Practice Nurse/HCA Event
Gali Siegal
Health Professional Engagement Facilitator Haringey and Enfield
March 2016
The continuum line
The Prevention Game
Motivational Interviewing
Ask patient what he/she already knows about topic
Ask permission to provide information, advice or
express concerns
Provide information
Ask what it means
Cancer Screening: Quick Quiz
How many cancer screening programmes are there in the UK?
What are the screening programmes?
Who is eligible? (age group)
What do you think the national targets are for each cancer
screening programme?
(% of people eligible for screening who should be screened?)
Screening
Programme
Who is invited
How it’s
conducted
Impact
National Target
Cervical
•
•
Women
Age 25 to 64
Smear test – can
be done at GP
practice
Estimated to save
5,000 lives a year
80%
Breast
•
•
•
Women
Age 50 – 70
women over 70 can
request
expanding to age 47
to 73
A mammogram is
done at a
screening centre
15,500 breast
cancers
diagnosed and
1,300 lives saved
70%
Men and women
Age 60 - 74
Over 74 can ask for kit
Testing kit
received in the
post. This is done
at home and
posted back
Only fully running
since 2010 but
estimated to save
2,000 lives by
2025
60%
•
Bowel
•
•
•
Cervical Screening Benefits
5000 lives estimated to be saved each year by screening
Screening women aged 25-34 reduces their risk of
developing cervical cancer by 45%
Screening women aged 35-64 reduces their risk of
developing cervical cancer by 60-80%
Since the start of screening in the 80’s cervical cancer
rates have almost halved
Bowel Screening Benefits
Screening 45 – 74 year olds can lower their risk of dying
from bowel cancer by 16%
Estimated to save more than 2000 lives each year by
2025
16 out of every 20 people with an abnormal result will
have a colonoscopy: 8 will have nothing abnormal found
6 will have polyps
2 will have cancer
FIT kit Pilot in London for 6 months
FIT - Faecal Immunochemical Test one sample only
FIT measures the human -specific ‘globin’ part of Hb,
not ‘haem’ which is detected using the current FOB
test
FIT uses an automated laboratory instrument to detect
blood
Breast Screening Pros and Cons
15500 breast cancers diagnosed through screening
each year
1300 lives are saved a year
But, for every life saved from breast cancer screening
around 3 women are over diagnosed
Why do we screen for cancer?
• All three programmes can help detect abnormal cells or tissue
changes before:
• They develop into full-blown cancer (cervical and bowelprevention is possible)
• They develops into an advanced stage
• Early detection means that there is a higher chance of
treatment being successful
•
• Prevention means we can stop cancers before they develop
• We can save more lives and improve cancer outcomes in the UK
The importance of catching cancer early
Detecting bowel cancer at an early stage vs late stage :
Early diagnosis of bowel cancer – 93% of those diagnosed survive 5 years or
longer
Late diagnosis of bowel cancer - less than 7% of those diagnosed will survive
five years or longer
Detecting breast cancer at an early stage vs late stage:
Breast cancer early diagnosis results in 99% survival rate of five years or longer
Late stage diagnosis of breast cancer - 15% survive five years or longer
Detecting cervical cancer at an early stage vs late stage:
Early diagnosis of cervical cancer - 96% survive their disease for five
years or longer.
Latest stage diagnosis of cervical cancer - 5%: survive their disease for
five years or longer.
Who do you think is less likely to
take up screening? Why?
BME Groups
Some socio economic groups
People with existing health
problems
Men
People with learning disabilities
No time/busy
Inconvenient
appointment time
Barriers to
Screening
(The Public)
Cultural
issues
Low perceived
risk of getting
cancer
Fear of pain
Patients with
physical
disabilities
Patients are
worried about
finding cancer
Didn’t get an
invitation
letter
Patients with
learning
disabilities
Embarrassment
Patients don’t
understand the
test
Patients are
unsure about who
to call to
rearrange
appointment
Role plays
Time for you to practice
Feedback
Share resources
with your
colleagues
Demonstrate
how to use the
kit to patients if
you can
Ask about
receipt/completion
of bowel screening
kits
Introduce
symptom
recognition and
screening info
into conversations
Be breast aware
yourselves
Convey optimism
about the
effectiveness of
treatment and
survival
Visit the resources for
health professionals
section at CRUK website –
topics for dealing
with mixed messages and
understanding research
Know where you
can obtain
patient info and
useful resources
to help you
Ask about
common
symptoms –
changes in body
and behaviours
Address the barriers
promote the
positives – ‘do it for
the family’ ‘early
presentation saves
lives’ ‘modern
treatments are
much better’
Familiarise yourself with common
risk factors so you are more ‘alert’
when supporting certain patients
Identify other ways to
discuss screening and
symptoms –
awareness weeks,
soap operas, news
items
Flag cervical
screening non
attenders
Provide easy to
read leaflets for
patients to read
Time to plot yourselves
on the continuum line
again…