Cancer: Older People

Question

14:37:00

Asked by

To ask His Majesty’s Government what steps they are taking to ensure a UK-wide approach to improving outcomes for older people with cancer.

My Lords, sadly, the risk of developing cancer increases as a person gets older. Health is a devolved matter, as your Lordships’ House will know, and the department is working with the NHS in England to improve outcomes for people of all ages with cancer. On my noble friend’s specific point, we are working to bring England in line with other nations by delivering a new national cancer strategy next year following the publication of the 10-year health plan.

I thank my noble friend for her Answer. I am sure she is aware that the UK’s cancer burden is projected to rise by around one-third by 2040, and 60% of those cancer diagnoses are expected to be among those aged 70 and above. Yet there is evidence that older people’s cancer care is not always provided to the level that it should be. Therefore, what assurances can she give me of actions the Government will take as part of the forthcoming cancer plan and the 10-year NHS plan to address these health inequalities in cancer care and treatment throughout the UK?

My noble friend is quite right that the incidence of cancer is expected to rise across the UK, especially in older people. I agree that older people can face specific barriers when accessing care. Following on from the independent review by the noble Lord, Lord Darzi, I assure my noble friend that the 10-year health plan and the subsequent cancer strategy for England, both to be published next year, will help us do more to prevent cancer, identify it early and treat people quickly. They will have regard to older people.

My Lords, I am delighted to hear that we will have a new cancer strategy. I have tried to get a debate in this House on that for two or three years now. Maybe the Minister will use her influence with the powers that be so that we can have a government-led debate on the cancer strategy. However, one of the reasons why our outcomes are poor is late diagnosis of cancer. Only 54% of cancers are diagnosed at stages 1 and 2. What plans do the Government have to improve early diagnosis of cancer?

I am sure the powers that be heard what the noble Lord said about a debate. On the point he raised, I absolutely agree that diagnosing cancer earlier, at stages 1 or 2, improves outcomes and survival. I refer again to the report by the noble Lord, Lord Darzi: we need to do more to diagnose people at an early stage. Work is already being undertaken to improve cancer screening uptake. We will continue to roll out targeted interventions such as the lung cancer screening programme, which has a particular effect and impact on the most disadvantaged areas. Members of your Lordships’ House will know that the Budget also committed to £1.5 billion of capital funding for new surgical hubs and diagnostic scanners, which will increase capacity.

My Lords, I will carry on the thread of questioning that the noble Lord, Lord Patel, started about early diagnosis. As the Minister said, it is very important that we look at early diagnosis. Noble Lords who are interested in diagnosis were looking forward to a follow-up report to the 2020 community diagnostic centre review by Sir Mike Richards. That was due to be published before the Budget, yet the Health Service Journal has reported that it has been shelved. Is this true? If so, can she explain why?

It is important that we concentrate on the biggest ever NHS consultation, because that will lead us to the 10-year plan, and all that we are doing will sit within that. As the noble Lord will know, we are committed to getting the NHS to diagnose cancer earlier, treat it faster and improve waiting times. One of the announcements in the recent Budget, which also shifts the dial, is that we will deliver an extra 40,000 scan appointments and operations every week. The 10-year health plan will set out our approach for shifting healthcare from sickness to prevention, including reducing the incidence of cancer.

My Lords, my mother-in-law died riddled with cancer that was not diagnosed until the very end of her life. We know that older people often suffer from several conditions and that frailty may minimise the treatment options available. The comprehensive geriatric assessment is the gold standard for the assessment of older patients and can make a real difference in outcome and cost, but cancer is not embedded in that assessment. Will the Minister find out from clinicians whether that might be possible?

I give my sincere condolences to the noble Baroness and her family. Yes, I will raise that. It is a good point to look at, and I thank her.

My Lords, what plans do the Government have, if any, to include older people in routine screening programmes, particularly given all the statistics that we have heard in the course of this Question and others? I have asked this question before. I have never heard an answer that I found entirely convincing. I am confident my noble friend will be able to help on this occasion.

I thank my noble friend for her confidence, and I will do my best. Decisions on screening, including the age ranges at which they operate, are made by the UK National Screening Committee. They have an upper and a lower age limit, which are based on evidence and kept under review. Current evidence does not support making changes to these ages. For breast screening, for example, self-referral is available for those over the age of 71 and for bowel screening it is available for those over 75. I confirm to her that this is all evidence-based, and we always keep an eye on the continuing evidence.

My Lords, I declare an interest in that I am a happy statistic of having survived more than five years after cancer treatment. But I know that I am not alone and that many others of the near 2 million cancer survivors have chronic conditions resulting either from cancer or from its treatment. Will the cancer strategy recognise and offer support to the many cancer survivors who have continuing chronic conditions resulting from their cancer?

I am glad that the noble Lord is, as he describes himself, a happy statistic. We are all grateful for that. I certainly share the view that there are a number of ongoing chronic conditions and impacts on other aspects, such as people’s mental health. The cancer strategy needs to look at this in its development, and I am grateful to him for highlighting it.

My Lords, as another happy statistic, I ask whether my noble friend thinks that older people are perhaps more reluctant than our younger friends to mention symptoms and are more inclined to say, “Oh, it’s nothing; I’ll get over it”. Would more public education programmes be useful in this regard?

I am glad that my noble friend is also a happy statistic—although I see all noble Lords as more than just statistics. She makes a very good point but it is not just about those who are older; many people are reluctant to consider taking action when they have symptoms. My request to them is that they do not wait and that they act. That is how we get things diagnosed earlier, to provide the right support and care. There is a lot of embarrassment about certain symptoms and I make the plea that people should not be embarrassed. Certainly, as she suggests, the new cancer strategy will take account of how we educate people as well as diagnose and treat them.