The current National Cancer Plan in Scotland, ‘Recovery and Redesign: An Action Plan for Cancer Services’ was published in 2020 and looked to build on the progress of the previous cancer strategy while responding to the immediate challenges to cancer care posed by COVID-19.
This plan ends next March, so now the Scottish Government have started the process of developing a new long-term cancer strategy.
England is in the process of developing a new 10-Year Cancer Plan too, and earlier this year we heard from three of our Campaigns Ambassadors about what they wanted to see in a comprehensive cancer plan for the next decade.
Now, we’re putting four of our Campaigns Ambassadors in Scotland in the spotlight.
Here’s what they told the Scottish Government that they want to see in an ambitious, world-leading cancer strategy in their responses to the public consultation on the new plan.
Diagnosing cancer early
Our Ambassador Rosa knows all too well the impact that cancer can have on someone’s life. She made it clear that early diagnosis must be at the centre of any new strategy.
“As a cancer survivor and a cancer widow, I know how terrifying having cancer can be and how horrible it is to watch your loved ones suffer from it.”
Rosa’s cancer was diagnosed at stage 1, meaning her cancer was caught early, and she emphasised the importance of screening and early detection.
“I was screened following symptoms, diagnosed with stage 1 uterine cancer and operated on in December 2008. I was given the all-clear on January 1st, 2009. In less than a month I was clear of cancer. Yet my husband, diagnosed in 2004 with Stage 4 lymphoma was not so lucky. He died within 3 months of his diagnosis.
“My diagnosis and all clear within a single month is a perfect illustration of how it can be done.”
And early diagnosis was a common theme of our Ambassadors’ submissions. Jo also highlighted specific recent advancements he thinks could be prioritised to help in this area:
“It is vital that cancer is detected as soon as possible for the individual to have the best potential outcome. I believe we should be working to develop the simple blood test to identify if the individual has or is likely to get cancer.”
Scotland has a strong track record on rolling out innovation in early detection and diagnosis, such as leading the way in the UK on rolling out the Cytosponge ‘sponge on a string’ test. Maintaining this leadership on supporting and adopting innovation will be vital to making progress on cancer in Scotland through the strategy.
The emphasis of our Ambassadors on early diagnosis echoes the vision that Cancer Research UK proposed to be included in the strategy – that by 2032 Scotland should lead the world in cancer early diagnosis, with at least 80% of all cancer patients diagnosed at Stage I and II – which, if achieved, could revolutionise cancer survival.
In addition to early diagnosis, Rosa recognised that not everyone has equal access to the healthcare services that were so important to her early diagnosis and treatment and that barriers to access faced by rural and island communities need to be overcome. This was another sentiment shared by several of our ambassadors, including Joanne and Tom.
“Coming from a rural background, greater public awareness of signs and symptoms of cancer and better access to advice would be of great benefit,” Joanne wrote.
“People in rural communities may also be less inclined to seek advice at an early stage due to limited nearby facilities. It is essential that people can access appropriate advice and care as early as possible.”
And access to cancer care in rural or island communities wasn’t the only inequality our Ambassadors addressed. Tom also highlighted the inequalities we see in the two biggest preventable causes of cancer: smoking and obesity.
“Marginalised groups have a higher incidence of cancers due to lifestyle and environmental factors outside of their control that can only be dealt with by political action to improve their social conditions.
“These groups are more likely to smoke and eat unhealthily. Government restrictions are needed to support more healthy behaviours.”
And Tom was right: our modelling suggests that, if current trends continue, the Scottish Government will miss their 2034 smokefree target.
That’s why Cancer Research UK has called for the Scottish Government to increase smoking cessation support in primary and secondary care, explore bold new measures to limit uptake of smoking, and work with the UK Government to increase investment in tobacco control.
We’ve also challenged them to set a subsequent target of 5% or less smoking prevalence in Scotland for all socioeconomic groups, including people in the most deprived areas.
One of the other key priorities that we included in our submission was the importance of transforming data collection, collation and analysis in Scotland.
Data gives us powerful insights that enable us to prevent more cancers, detect more cancers earlier and develop more effective treatments. However, the full potential of data can only be harnessed if the underlying infrastructure is in place to support its collection and reporting.
This is a priority shared by our patient involvement network in Scotland, 96% of whom were supportive of data related to their care being used to improve cancer services and research.
If we are to see improvement in cancer outcomes this can only be achieved by analysis of as much data as possible, particularly in the research field. Providing the proper safeguards are built into the use of data, I fully support this.
– A person affected by cancer in Scotland, consulted by CRUK.
Leading the charge
Scotland has consistently led the UK in implementing improvements across the cancer pathway.
In prevention, Scotland has been world-leading in tackling alcohol harm through introducing minimum unit pricing in 2018 and was the first UK nation to outlaw smoking in enclosed public places in 2006.
Scotland also has a strong research base for its size, significantly overperforming in competitive research funding per capita.
However, reducing cancer incidence and transforming cancer outcomes requires sustained action across the pathway.
Unlocking the opportunities that a renewed cancer strategy contains will require more than just relying on existing strengths. It also requires significantly enhancing the three key enablers of success we outlined in our submission: workforce, funding, and data.
It is essential that ambitions are matched by sufficient and sustainable funding across the whole 10-year span of the strategy, and that long-term funding plans to address the chronic shortages we currently see in workforce specialties are set out to meet future demand on cancer services.
This is why a new cancer strategy has the potential to be a major milestone for people affected by cancer in Scotland.
If the Scottish Government can seize this moment to build on their previous momentum through the new strategy, they can once again lead the way in driving transformation across cancer prevention, cancer services, and research.
“Let this Scottish 10-year cancer strategy lead the way,” Rosa wrote. “We can do it. We have the insight, the vision, and the determination. Let’s carry it out.”