Week 5 - Early Detection & Prevention of Cancer

Question 1

What are the risk factors for cancer

Answer 1

1. Lifestyle factors
   
   • diet and activity
   • smoking
   • alcohol
   • obesity
2. Genetics
3. Famly History
4. Air pollution

Question 2

Why is early cancer detection important

Answer 2

Cancer is leading cause of premature deaths in the world + is a helathcare burden

• If caught symtpomatically at a later stage patient will have worse outcomes
  - as symtoms mean cancer has metastisised
• Screening programmes ↓ mortality + morbidity (state of being unwell from a disease) and improve outcomes
• Detecting early = will require less intensive treatment (less stress + burden on healthcare workforce)

Question 3

How does bowel screening work

Answer 3

If diagnosed early > 90% can be successfully treated
- if caught early surgical treatment will completely cure you

NHS Bowel Screening Programme
- Men and women aged 60-74 are sent home a testing kit every 2 years
- use kit to collect small sample of poo
- check sample for blood whcih could be caused by cancer
- use FIT because its more accurate and easier to use, detects smallest traces of blood
-

Question 4

How do we detect breast cancer

Answer 4

• Use breast cancer screening
• Feel around breasts (for lumps, thickened tissue)
• Breast looks or feels different

Question 5

How does breast cancer screening work

Answer 5

X-ray (mammogram) spots cancer that are too small to see or feel

Breast Screening:
- offered to women aged 50-71
- after 71 stop recieving invite but can still book appointment by contacting local screening unit
- invited to screening within 3 years of 50th birthday
- MAY be ELIGIBLE for screening <50 years if have ↑ risk of developing cancer

Inclusion Criteria for Invitation:
- Trans men that were female at birth + haven’t had breast removed
- Trans women (male at birth) who have taken female hormones
- Non-binary (female at birth)
- Cisgender women

Question 6

How do we detect cervical cancer

Answer 6

• Cervical cancer screening

Question 7

How does cervical cancer screening work

Answer 7

NHS Cervical Screening Programme:
- Offered to people with cervix aged 25 to 64
- routine screening every 3 years till 49
- routine screeing every 5 years till 64
- MAY have shorter intervals depending on result
- Samples taken are tested for HPV (virus)
- HPV causes cervical cancer
- If test positive for HPV sample is further analysed to detect cell abnormality

Inclusion Criteria
- Cisgender women (women born female, remained female)
- Trans men (female at birth)
- Non-binary (female at birth)

Question 8

Why is there no prostate cancer screening

Answer 8

Because PSA test is not reliable enough
- some men may have ↑ PSA but NOT have prostate cancer or have ↓ PSA and have prostate cancer
- PSA is a godd marker for the cancer BUT its NOT SPECIFIC ENOUGH

PSA = prostate specific antigen
- biomarker found in blood
- produced by prostate cancer cells

Question 9

Why is there no lung cancer screening

Answer 9

Instead have TARGETED LUNG HEALTH CHECKS
- lung cancer is oftend diagnosed at later stages as there are less signs earlier on
- checks help diagnose cancer at earlier stages (stage 1-2)

Targeted Lung Health Checks (TLHC):
- Offered to current or former smokers aged 55 to 74
- Assessment with nurse; asses breathing, lifestyle, family + medical history
- Based on answeres may be invited for a low dose CT scan (takes detailed pic of lungs)
- If results are concerning, invited for another low dose CT scan and possible treatmenr

Question 10

How does the National Prevention Programme work

Can help with lung Cancer Prevention

Answer 10

Delivers talored help for lifestyle factors such as tobacco addiction, alcohol and obseity
- unhealthy lifestyle factors ↑ risk of developing lung cancer

Examples of the prevention programme
- Adverts (smoking, obesity)
- media targets population to help stop
- Self-examination
- Making every contact count
- give little info. when meet patients can improve their health
- Prevention Campaigns

Question 11

What are barriers to screening

i.e. what would prevent patient from attending

Answer 11

• Language barrier
  - MAIN ISSUE with low screening engagement
• Fear of the unknown
• Fear of positive result
• Mistrust of healthcare from past experiences
  - i.e. racism, microagression, poor treatment
• Shame of cancer, anxiety, embarrasment
• Social media / online diagnosis
• Access
  - hard to get GP appointments
  - not recieveing invitations, registration issues
• Costs
• May be using medicines they believe prevent cancer
  - i.e. herbal, vitamin supplements, homeopathy

The way patients engage with healthcare programmes can be affeted by individual factors, social + community networks, socio-economic envrionmental conditions (i.e. work, eductaion, living conditions)

Question 12

What is the role of pharmacist in reducing cancer risk

Answer 12

Overcoming barriers, helping patient get access to screening as they are the most accessible point of healthcare
- local areas, don’t need appointment, can have private consultations + can make interventions through regular interactions with patient
- help reduce health inequalities as everyone can access them
- most cancers present in primary care + most have symptoms pharmacist may identify
- can lead to early diagnosis via direct referal to diagnsotic centre

How to Overcome Language Barrier:
- Use multimedia campaigns within community pharmacy to promote screening programmes
- Use inclusice posters to reflect diversity
- Have info. with translation into diff. languages available (e.g. scan QR code for translations)
- allows diff. backgrounds to gain access + info.
This improves patient knowledge, trust anf intent to engage with programme