Asked by: Lord Aberdare (Crossbench - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what assessment they have made of (1) the number, and (2) the proportion, of pancreatic cancer patients whose diagnosis is made following an emergency admission; and how those figures compare with patients of other cancer types.
Answered by Lord Prior of Brampton
The Routes to Diagnosis study defines a methodology by which the route the patient follows to the point of diagnosis can be categorised, in order to examine demographic, organisational, service and personal reasons for delayed diagnosis.
Administrative Hospital Episode Statistics data are combined with cancer waiting times data, data from the cancer screening programmes and cancer registration data from the National Cancer Data Repository.
Using these datasets every case of cancer registered in England which was diagnosed in 2006-2010 is categorised into one of eight ‘Routes to Diagnosis’.
The methodology is described in detail in the British Journal of Cancer article Routes to Diagnosis for cancer - Determining the patient journey using multiple routine datasets, which can be found at the following link and is also attached.
http://www.nature.com/bjc/journal/v107/n8/full/bjc2012408a.html
Emergency presentations are defined as “an emergency route via A&E, emergency GP referral, emergency transfer, emergency admission or attendance.” More detail can be found in the attached technical document.
Data on all malignant neoplasms (excluding non-melanoma skin cancer) and pancreatic cancer was taken from the “Routes to diagnosis 2006-2010 workbook (a)” – this can also be found in the attached article.
The Emergency Presentation Route is the principle route to diagnosis for patients with pancreatic cancer. This reflects the lack of easily recognisable symptoms of early disease, with advanced disease often presenting with the acute onset of jaundice.
The percentage of emergency presentations ranges from 3% for melanoma to 63% for acute lymphoblastic leukaemia.
Table 1: Percentage of diagnoses by emergency presentation route, England, persons, 2006-2010
Number of cases | Number of cases by emergency presentation route | Percentage by emergency presentation route | |
| a | b | (b/a)x100 |
All malignant neoplasms (excl. non-melanoma skin cancer) | 1,272,584 | 291,391 | 23% |
Pancreas | 34,012 | 16,460 | 48% |
Asked by: Lord Aberdare (Crossbench - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what plans they have to increase the capacity of imaging services available to pancreatic cancer patients across the National Health Service, including computerised tomography scans.
Answered by Lord Prior of Brampton
NHS England has a published service specification for pancreatic cancer which clearly defines what it expects to be in place for providers to offer evidence-based, safe and effective pancreatic cancer services. This service specification has been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe core and developmental service standards.
Patients being treated at cancer units should have access to an upper gastrointestinal cancer nurse. All district general hospitals should have such a person in post. If the patient is transferred to a cancer centre they should then have access to a pancreatic nurse specialist. This person should see every patient and become their key worker.
Patients with suspected pancreatic cancer are usually first investigated by an ultrasound scan. If this shows biliary dilatation, or anything else suspicious, the patient should then be sent for a pancreas protocol computerised tomography scan which is the best investigation for identifying pancreatic cancer.
Increasing the capacity of diagnostic and imaging services is clearly recognised as a priority for the National Health Service and it is has been raised as a key issue by the independent Cancer Taskforce, as well as by the Cancer Waiting Times Taskforce. We expect a new cancer strategy to be published this summer which will set out the strategy for the system for the next five years and will include consideration of the whole cancer pathway, including the capacity of diagnostic services.
In addition, NHS England is testing various approaches to new models of care which could potentially deliver improved access to diagnostic services for cancer patients, including those with pancreatic cancer.
Asked by: Lord Aberdare (Crossbench - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what steps they are taking to ensure that all pancreatic cancer patients have access to a clinical nurse specialist.
Answered by Lord Prior of Brampton
NHS England has a published service specification for pancreatic cancer which clearly defines what it expects to be in place for providers to offer evidence-based, safe and effective pancreatic cancer services. This service specification has been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe core and developmental service standards.
Patients being treated at cancer units should have access to an upper gastrointestinal cancer nurse. All district general hospitals should have such a person in post. If the patient is transferred to a cancer centre they should then have access to a pancreatic nurse specialist. This person should see every patient and become their key worker.
Patients with suspected pancreatic cancer are usually first investigated by an ultrasound scan. If this shows biliary dilatation, or anything else suspicious, the patient should then be sent for a pancreas protocol computerised tomography scan which is the best investigation for identifying pancreatic cancer.
Increasing the capacity of diagnostic and imaging services is clearly recognised as a priority for the National Health Service and it is has been raised as a key issue by the independent Cancer Taskforce, as well as by the Cancer Waiting Times Taskforce. We expect a new cancer strategy to be published this summer which will set out the strategy for the system for the next five years and will include consideration of the whole cancer pathway, including the capacity of diagnostic services.
In addition, NHS England is testing various approaches to new models of care which could potentially deliver improved access to diagnostic services for cancer patients, including those with pancreatic cancer.