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Archive February 2008
LUNG
CANCER |
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What we know
What information do we have about the Eastern Board
area?
What is the result of this on our health locally?
Policies
What is happening in the Eastern Board area?
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| What
we know |
| Cancer is a term for
a group of diseases in which abnormal cells start to develop in
a part of the body e.g. the lung. These abnormal malignant cells
continue to grow and then spread (metastasize) through the blood
stream and lymphatic system to other parts of the body. Lung cancer
is strongly linked to cigarette smoking. The rate of lung cancer
reflects smoking patterns of previous decades.
The Northern Ireland Cancer Registry (NICR), based
in Queen's University Belfast, collects information about cancer
in Northern Ireland from a range of sources to get the best possible
estimate of the number and type of cases of cancer in Northern Ireland.
The NICR then provides information about the number of new cases
of cancer each year (incidence) and the number of existing cases
of cancer (prevalence) for the different cancer types. The NICR
now has data going back to 1993, which enables us to see the trends
in cancer types over time.
Cancer is predominantly a disease of middle age
and old age. According to data from the Northern Ireland Cancer
Registry, half of all patients are aged 68 or over at the time of
diagnosis. Females have a 1-in-8 chance and males a 1-in-6 chance,
of dying of cancer by age 74. One in three people will develop some
type of cancer during their lifetime, but the news is not all bad.
With increasing research and new treatment, many types of cancer
can be cured or at least halted for a time.
The Northern Ireland Cancer Registry reports that in 2001 lung cancer
was the second most common cancer in males and third most common
cancer in females in Northern Ireland, representing approximately
13% of male and 7% of female cancers registered. Half of the cases
occurred in people aged over 70 years. Lung cancer was the most
common cause of cancer death in males and second most common in
females.
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| What information
do we have about the Eastern Board area? |
| In 2005, there were 1591 deaths
from all causes in residents of the Eastern Board area: 810 males
and 781 females. Of these, 365 people died from lung cancer: 226
males and 139 females. When we look back to 1991, the death rate
for lung cancer shows an interesting difference between males and
females. The death rate in males has fallen during this period,
while the death rate in females has remained static. This in part
reflects the smoking habits of previous decades and the trend is
likely to continue for some time to come. (The rates fluctuate from
year to year, because of the relatively small numbers of deaths).
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| What is
the result of this on our health locally? |
Research has identified
some factors that increase a person's risk of developing some type
of cancer. The best-known risk factor for lung cancer is cigarette
smoking. It is important to realise that this does not mean that
only smokers get lung cancer or that all smokers get lung cancer,
but those who smoke 20 cigarettes a day are 10 times more likely
to get lung cancer than non-smokers.
Tobacco smoking is not just associated with lung
cancer. In fact, tobacco smoke exposure is responsible for approximately
one-third of all cancer deaths and more than 85% of all lung cancer
deaths. The risk of cancer begins to decrease soon after a smoker
quits and the risk continues to decline gradually each year after
quitting. Stopping people from smoking is the single most important
factor in reducing the risk of cancer. Other factors related to
lung cancer are exposure to environmental tobacco smoke, asbestos,
radon gas and some industrial products.
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| Policies |
| The
Report of the Expert Advisory Group on Cancer, "A Policy Framework
for Commissioning Cancer Services" (the Calman/Hine Report),
1995, recommended a framework for cancer services in England and
Wales.
The Cancer Working Group of the Department of Health
and Social Services (N.I.) built upon the Calman/Hine principles
and in its 1996 report "Cancer Services: Investing for the
Future" (the Campbell Report), described a structure for future
cancer services in Northern Ireland.
The Eastern Health and Social Services Board Palliative
Care Strategic Action Plan 2002 – 2007 was published in 2002
(Palliative Care Services - The Next 5 Years).
It is also important to review and consider recent
guidance:
Regional Guidance:
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Review of clinical genetic services
in Northern Ireland |
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Gynaecological Cancer Guidelines |
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Dermatological Cancer Guidelines |
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Haematological Cancer Guidelines |
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Endocrine Cancer Guidelines |
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Lymphoedema Review |
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Review of Clinical Pathology Laboratory Services |
National Institute of Clinical Excellence (NICE)
National Collaborating Centre for Cancer Guidance:
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Breast Cancer Service Guidance
(August 2002) |
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Urological Cancers Service Guidance (September
2002) |
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Haemato-oncology cancer service guidance (October
2003) |
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Supportive and Palliative care (March 2004) |
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Head and Neck Cancers (Anticipated publication
date October 2004) |
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Lung cancer (Anticipated publication date
January 2005) |
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Colorectal cancer (Anticipated publication
date January 2005) |
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Referral guidelines for suspected cancer (Anticipated
publication date March 2005) |
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Prostate cancer ((Anticipated publication
date to be confirmed) |
NHS Modernisation Agency Cancer Services Collaborative
Service Improvement Guides:
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Multidisciplinary Team Resource
Guide |
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Breast Service Improvement Guide |
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Chemotherapy Service Improvement Guide |
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Radiotherapy Service Improvement Guide |
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Upper GI Service Improvement Guide |
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Urology Service Improvement Guide |
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Patient and Carer Experience : A Service Improvement
Guide |
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| What is happening
in the Eastern Board area? |
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Northern Ireland Cancer Network
The Eastern Board is currently in the
process of reviewing cancer service provision in light of recent
regional developments such as the Northern Ireland Cancer Network
(NICaN) and the Regional Cancer Services Framework group. This
process will also review progress against the EHSSB
Cancer Commissioning Group report recommendations. |
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In 1997 the
Eastern Health and Social Services Board (EHSSB)
convened a multi-agency Cancer Commissioning Group, with the
remit to oversee implementation of policy on the prevention
and treatment of cancer for Eastern Board residents. Seven
Cancer Commissioning sub-groups were established to inform
this process:
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breast cancer |
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lung cancer |
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gastrointestinal cancers, including
colorectal |
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gynaecological cancers |
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urological cancers |
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palliative care |
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cancer prevention |
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In March 1998, the Eastern Board
established the EHSSB Cancer
Implementation Group which was tasked to take forward the recommendations
from the Cancer Commissioning Group report. Site-specific implementation
subgroups were (re)convened to take forward this work in phases. |
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Published in August, the
EHSSB Cancer Commissioning Group report described the recommendations
for future cancer services for Eastern Board residents. The
report covered all aspects of care from prevention through to
cure and palliation and outlined the strategic and resource
implications of the proposed service models. |
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Service quality standards, professional
standards and care pathways for breast, colorectal, and lung
cancer were outlined separately in the report ‘Cancer
Services in the Eastern Health and Social Services Board: Quality
Standards and Care Pathways’. |
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The Eastern Board area contains
the Cancer Centre and two Cancer Units at the Belfast City Hospital
and the Ulster Hospital. However, given the varied initial clinical
presentation of malignant disease, general specialties within
all acute Eastern Board hospitals continue to have an important
role in investigation and diagnosis, local treatment where appropriate,
and referral onward as part of multidisciplinary treatment. |
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Regional Cancer Centre
Construction of the new Regional Cancer
Centre building on the Belfast City Hospital site commenced
in 2002. The work is progressing well and is on schedule, with
the building expected to be opened for clinical service at the
start of 2006. Two lung cancer nurse specialists have been appointed
to the Cancer Centre, working across the Belfast City Hospital
and Royal Hospitals sites. |
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Smoking prevention and cessation
Stopping people starting to smoke in the
fist place is one of the most important ways of ensuring that
the health of our residents will be improved in the future.
This is particularly important for children and young people.
In the Eastern Board area there are initiatives to educate and
inform young people of the dangers of smoking and encourage
them to withstand peer pressure to begin smoking. For those who are already
smokers, services are now in place to help them stop. Smoking cessation
co-ordinators have been appointed to all Boards in Northern Ireland
and are working with a wide range of health professionals and other
organisations to set up smoking cessation services.
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For further information on this topic please contact us at publichealth@ehssb.n-i.nhs.uk
Eastern Health and Social Services Board Champion
House, 12-22 Linenhall Street, Belfast BT2 8BS Telephone: (028)
9032 1313 Fax: (028) 9055 3681 Text Phone:(028) 9032 4980 Website:
www.ehssb.org
E-mail: pr@ehssb.n-i.nhs.uk Site designed by areema.co.uk |
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