Category: Cancer

Public Health

Current awareness updates

Alcohol is one of the biggest risk factors for breast cancer.
World Health Organization (WHO); 2021.
[Alcohol is classified as a Group 1 human carcinogen by IARC. It is causally linked to 7 types of cancer. Besides female breast cancer, it increases the risk of developing oral cavity (mouth), pharynx (throat), oesophagus (gullet), liver, larynx (voice box) and colorectum (large intestine and rectum) cancers. There is no safe level of alcohol consumption. The risk of breast cancer increases with each unit of alcohol consumed per day.]

Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management.
National Institute for Health and Care Excellence (NICE); 2021.
[This guideline covers diagnosing and managing myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome (ME/CFS) in children, young people and adults. It aims to improve awareness and understanding about ME/CFS and when to suspect it, so that people are diagnosed earlier. It includes recommendations on diagnosis, assessment and care planning, safeguarding, access to care and managing ME/CFS and its symptoms.]

Eligible for a free flu vaccine this winter? Don’t wait, book it.
UK Health Security Agency (UKHSA); 2021.
[With flu and COVID-19 expected to be in wide circulation together this winter, UK Health Security Agency is urging more people than ever to get their free flu vaccine, if they are eligible. In this blog the UK Health Security Agency answers some common questions about this year’s flu season.]

The use of wearables and health apps and the willingness to share self-collected data among older adults.
Seifert A. Aging and Health Research 2021;1(3):100032.
[The aim of this study was to examine the extent to which older adults utilize mobile health tracking tools in everyday life and their willingness to share the collected health-related data with doctors, health insurance companies, or research institutions. 75.0% of the participants used at least one mobile device; 22.9% used health-related apps. Participants were more often willing to share their data with doctors than with health insurance companies or researchers.]

Changes in childhood experimentation with, and exposure to, tobacco and e-cigarettes and perceived smoking norms: a repeated cross-sectional study of 10–11 year olds’ in Wales.
BMC Public Health; 2021.
[Children’s experimentation with and exposure to tobacco, and their perceptions of smoking as a normative behaviour, have continued to decline alongside growth in exposure to e-cigarettes. Although a large majority of pupils reported they minded people smoking around them, there was some evidence of diminishing disapproval of secondhand smoke since 2007.]

Understanding Sexual Aggression in UK Male University Students: An Empirical Assessment of Prevalence and Psychological Risk Factors.
Sexual Abuse; 2021.
[University-based sexual aggression is an international public health issue; however, to date, there have been no formal assessments of the prevalence or psychological indicators associated with the proabuse behaviors of the most common perpetrators at UK universities: heterosexual male students.]

Patients as team members: Factors affecting involvement in treatment decisions from the perspective of patients with a chronic condition.
Health Expectations; 2021.
[From the patients’ perspective, this study shows that there is no one-size-fits-all approach to involving patients more actively in their healthcare journey. Strategies aiming to enhance active patient involvement among patients with a chronic condition should consider this diversity in perspectives among these patients.]

Lead exposure in children: surveillance reports (from 2021).
UK Health Security Agency (UKHSA); 2021.
[Results of laboratory-based surveillance of elevated blood lead concentrations in children in England.]

Seasonal flu vaccine uptake in children of school age: monthly data, 2021 to 2022.
UK Health Security Agency (UKHSA); 2021.
[Cumulative vaccine uptake data for the childhood seasonal flu programme in England.]

Review: Physical activity interventions for the mental health and well-being of adolescents – a systematic review. [Abstract]
Hale GE. Child and Adolescent Mental Health 2021;26(4):357-368.
[Rates of physical activity decline throughout adolescence, and evidence indicates that this has an adverse impact on psychological health. This paper aims to synthesise available evidence for physical activity interventions on the mental health and well-being of young people (11-19 years) from the general population.]

Telehealth interventions: remote monitoring and consultations for people with chronic obstructive pulmonary disease (COPD). [Abstract]
Janjua S. Cochrane Database of Systematic Reviews 2021;7:CD013196.
[BACKGROUND: Face-to-face visits with health professionals can be hindered by severity of COPD or frailty, and by people living at a distance from their healthcare provider and having limited access to services. Telehealth technologies aimed at providing health care remotely through monitoring and consultations could help to improve health outcomes of people with COPD.]

Strategies to improve smoking cessation rates in primary care. [Abstract]
Lindson N. Cochrane Database of Systematic Reviews 2021;9:CD011556.
[OBJECTIVES: To assess the effectiveness of strategies intended to increase the success of smoking cessation interventions in primary care settings. To assess whether any effect that these interventions have on smoking cessation may be due to increased implementation by healthcare providers.]

Living with dementia: my life, my goals.
Alzheimer’s Society; 2021.
[A new self-help guide for people living with dementia. The guide helps people with dementia achieve their goals step-by step. It was created by researchers from the GREAT trial in collaboration with people living with dementia.]

Public Health

Current awareness updates

Are we Improving Access to Psychological Treatment for everyone?
The Mental Elf; 2021.
[Bibire Baykeens reviews a general population cohort study which suggests that recent migrants are less likely to use the Improving Access to Psychological Treatment programme.]

Flu in prisons and secure settings.
UK Health Security Agency; 2021.
[This guidance, updated for 2021/22, details how to respond to cases of seasonal flu in prisons and other secure settings (e.g. immigration removal centres; secure training centres), including vaccination, treatment and managing outbreaks.]

Flu in the children and young people’s secure estate.
UK Health Security Agency; 2021.
[This guidance, updated for 2021/22, details how to respond to cases of seasonal flu in the children and young people’s secure estate (e.g. young offender institutions, secure training centres, secure children’s homes), including vaccination, treatment and managing outbreaks.]

Flu vaccination in schools.
Department of Health and Social Care (DHSC); 2021.
[Flu vaccination guidance and resources for schools.]

Cold weather plan: action cards for cold weather alert service.
Department of Health and Social Care (DHSC); 2021.
[These action cards summarise advice on how different organisations need to respond to cold weather alert levels 0 through 4.]

Access to palliative care: the primacy of public health partnerships and community participation.
Mills J. The Lancet Public Health 2021;:doi.org/10.1016/S2468-2667(21)00213-9.
[This viewpoint highlights that palliative care is a public-health concern and the need to promote equity in access to palliative care through public-health partnerships that prioritise community development and participation in end of life care.]

Forthcoming UK asthma guidelines: an opportunity to improve asthma outcomes.
Bush A. The Lancet 2021;:doi.org/10.1016/S0140-6736(21)02244-3.
[Comment proposes the guideline committees set SMART objectives, e.g. reporting of patients who access less than 80% of their inhaled corticosteroid requirements, suggesting adoption of their proposed strategies could help the guidelines group rise to the challenge of improving asthma outcomes.]

A public health approach to estimating the need for long COVID services.
Journal of Public Health; 2021.
[This paper illustrates how a public health approach was used to influence and inform the development of post-COVID services across two Integrated Care Systems (ICSs). The findings have been valuable in informing early service developments, engaging with managers and clinicians, and supporting applications for funding at a local level.]

Self-Care Readiness Index.
Global Self Care Federation; 2021.
[The Self-Care Readiness Index (SCRI) is a research and policy initiative by the Global Self Care Federation and supported by the World Health Organisation (WHO). It explores enablers of self care across the health systems of 10 countries, including the UK.]

Online services in general practice: patterns of use and barriers to uptake.
Public Health England (PHE); 2021.
[This project is in line with the national ambition to support the adoption of a range of technology initiatives in general practice. The aims were to understand the needs of the population relating to the effectiveness of online services to support general practice, and identifying groups and exploring barriers and enablers to the use of GP online services. The report is mainly intended for commissioners and providers of GP services.]

Voluntary, Community and Social Enterprise (VCSE) Health and Wellbeing Programme: An evaluation.
Department of Health and Social Care (DHSC); 2021.
[An independent evaluation of the Voluntary, Community and Social Enterprise (VCSE) Health and Wellbeing Programme.]

Best foot forward: exploring the barriers and enablers to active travel among 50–70 year olds.
Centre for Ageing Better; 2021.
[This report finds that too many people in their 50s and 60s will remain physically inactive unless we redesign our neighbourhoods to encourage walking and cycling. The report, which looked at the barriers people in this age group face to walking and cycling, says that action is needed from national and local government, service providers and health systems to get people moving.]

Adult social care in England, monthly statistics: October 2021.
Department of Health and Social Care (DHSC); 2021.
[Experimental statistics on a range of topics including infection control measures, coronavirus (COVID-19) vaccinations and testing for COVID-19 in adult social care settings.]

Transport initiatives to increase uptake of breast screening programmes.
Carried out by Frankie Marcelline from Brighton and Sussex on 12/10/2021
[The evidence search report covers studies on the links between breast cancer screening uptake and ease of transport to appointments. In Tower Hamlets an initiative for encouraging uptake of breast cancer screening appointments includes transport-related support.]


Public Health

Current awareness updates

Increasing COVID-19 vaccination rates amongst vulnerable groups: summary advice for GPs.
Royal College of General Practitioners (RCGP); 2021.
[GPs will be aware of the disparity in uptake of the COVID-19 vaccine between different population groups; often, the groups most at risk from infection and serious illness are those least represented at vaccination centres. We continue to collect examples, case studies or evidence on what works in addressing this issue.]

Vaccination of people working or deployed in care homes: operational guidance.
Department of Health and Social Care (DHSC); 2021.
[From 11 November 2021, anyone working or volunteering in a care home will need to be fully vaccinated against coronavirus (COVID-19), unless exempt.]

JCVI statement, August 2021: COVID-19 vaccination of children and young people aged 12 to 17 years.
Department of Health and Social Care (DHSC); 2021.
[This statement sets out JCVI’s latest considerations and advice regarding the potential extension of the COVID-19 vaccination programme to children and young people.]

JCVI issues updated advice on COVID-19 vaccination of young people aged 16 to 17.
Public Health England (PHE); 2021.
[The Joint Committee on Vaccination and Immunisation (JCVI) is today advising that all 16 and 17 year olds receive their first dose of the Pfizer-BioNTech vaccine.]

COVID-19 vaccination: resources for children and young people.
Public Health England (PHE); 2021.
[Information for eligible children and young people on COVID-19 vaccination.]

PHE women’s reproductive health programme 2020 to 2021.
Public Health England (PHE); 2021.
[Progress update on the PHE reproductive health programme, including a new return on investment tool and the next steps for 2021 to 2022. ‘Extending PHE’s contraception return on investment tool: maternity and primary care settings’ outlines a new return on investment (ROI) model for contraception in maternity and the provision of long-acting reversible contraceptives (LARC) in primary care, building on the existing contraception ROI tool published in 2018.]

BHIVA guidance for virtual consultations for people with HIV: May 2021.
British HIV Association (BHIVA); 2021.
[This guidance was released in May 2021 in response to the increased proportion of consultations carried out remotely due to COVID-19. The guidance highlights issues important for safe and effective consultation, including awareness of the limitations of remote consultation.]

Expanding access to naloxone.
Department of Health and Social Care (DHSC); 2021.
[Naloxone is a drug that reverses the effects of an opioid overdose and can help to prevent overdose deaths. We are seeking responses to this consultation to assess the viability of proposals to widen access to naloxone by expanding the list of services and individuals that can give it out without a prescription or other written instruction.]

Quality indicators in lung cancer: a review and analysis. [Abstract]
Chiew KL. BMJ Open Quality 2021;10(3):DOI: 10.1136/bmjoq-2020-001268.
[Conclusions: We found a large number of published QIs in lung cancer but they focused on relatively few areas not reflective of patterns of contemporary practice. We identified gaps in lung cancer QIs especially for systemic therapies, radiotherapy, palliative care and patient-reported outcomes. In order to comprehensively assess the care of patients with lung cancer, future efforts should focus on developing readily measurable QIs in these areas…]

Now or never: A systemic investment review of mental health care in England.
Centre for Mental Health; 2021.
[This report, commissioned by the NHS Confederation’s Mental Health Network, sets out ten key areas where strategic investment could solve systemic issues in the mental health system, with significant benefits to the lives of people with mental health difficulties and their experiences of support.]

The role of epigenetics in psychological resilience. [Abstract]
Smeeth D. The Lancet Psychiatry 2021;8(7):620-629.
[In this Review, we propose a new conceptual model for the different functions of epigenetic mechanisms in psychological resilience. After reviewing empirical evidence for the various components of the model, we identify research that should be prioritised and discuss practical implications of the proposed model for epigenetic research on resilience.]

Effect of telehealth interventions on quality of life in cancer survivors: A systematic review and meta-analysis of randomized controlled trials.
Li J. International Journal of Nursing Studies 2021;122:103970 .
[Telehealth interventions are effective and alternative methods for improving quality of life among cancer survivors. The most effective approach was application-based intervention, the most common approach was website-based intervention, and in terms of intervention durations, the short-term telehealth intervention was the most effective. Most telehealth interventions included breast cancer survivors.]

Public Health

Current awareness updates

Tick bite risks and prevention of Lyme disease: resources.
Public Health England (PHE); 2021.
[Toolkit and resources for local authorities and other stakeholders to raise awareness of the potential risks created by ticks and tick-borne disease in England. You can choose to co-brand leaflets and posters with PHE by adding your logo to the Word files or simply download the PDFs.]

Holiday activities and food programme 2021.
Department for Education (DfE); 2021.
[This document provides information for local authorities delivering the holiday activities and food programme in 2021. In 2020 the government announced that the holiday activities and food programme, that covers the Easter, summer and Christmas holidays, will be expanded across the whole of England in 2021. There will be up to £220 million available to local authorities to coordinate free holiday provision, including healthy food and enriching activities.]

New cross-government unit to tackle drug misuse following major independent review.
Department of Health and Social Care (DHSC), Home Office, and Public Health England (PHE); 2021.
[The new unit aims to end illegal drug-related illness and deaths. The rise in drug misuse poisoning deaths has been driven by increases in heroin deaths which have doubled in this time and other substances such as cocaine have seen notable recent increases. The proportion of 11 to 15-year-olds who use drugs has increased in recent years with one in three 15-year-olds saying they took drugs in the last year.]

Tackling obesity: the role of the NHS in a whole-system approach.
The King’s Fund; 2021.
[Rates of obesity in England are high and rising, with a strong systemic relationship between obesity and deprivation. Rates are also higher in women than in men, and in some ethnic minority groups compared to the white British group. This briefing explores the role of the NHS in tackling obesity, focusing on how the NHS can work with local partners and engage with communities to deliver targeted interventions to treat and prevent obesity.]

Effectiveness of complementary therapies in cancer patients: a systematic review.
Guerra-Martin MD. International Journal of Environmental Research & Public Health 2021;18(3):1017.
[The findings reveal some effective complementary therapies: auriculotherapy and acupuncture, laser moxibustion, hypnosis, Ayurveda, electroacupuncture, progressive muscle relaxation and guided imagery, yoga, phytotherapy, music therapy and traditional Chinese medicine. On the other hand, electroacupuncture, laser moxibustion and traditional Chinese medicine presented adverse effects, and kinesiology did not show effectiveness.]

Wellbeing toolkit for Alcohol Related Brain Damage (ARBD).
Penumbra; 2021.
[As well as providing important medical information about ARBD and alcohol use, the toolkit covers key practical and holistic information on recovery – including information on reducing stress, improving memory, coping with challenging emotions without using alcohol, nutrition and exercise, connecting with others and the community, along with guidance on improving digital skills, budgeting and knowing your rights. It includes a podcast of relaxation exercises.]

What support do young people with sickle cell disease need when moving into adult services?.
NIHR Evidence; 2021.
[This research suggests that non-specialist healthcare services are failing young people with sickle cell disorder. This is a critical period in their development when they are learning to live as adults. It is difficult to manage conflicting demands, such as wanting to work hard at school but needing to rest to avoid pain. Researchers suggest healthcare professionals shouuld work with schools to create supportive services that can help young people to achieve their life goals.]

Loneliness is strongly linked to depression in older adults in a large, long-term study.
NIHR Evidence; 2021.
[Depression is a major public health problem that is growing worldwide. The causes are complex and vary from person to person. However, new research estimates that up to one in five cases of depression among older adults could be prevented by reducing loneliness. The study therefore has important public health implications, highlighting the need for comprehensive action across society to combat loneliness.]

HIV infection and AIDS.
Clinical Knowledge Summary (CKS); 2021.
[This CKS topic has been updated.]

Could a decision support tool help to guide mental health treatment in primary care?
The Mental Elf; 2021.
[Linda Gask reviews a recent randomised controlled trial on the clinical efficacy of a Decision Support Tool (Link-me) to “guide the intensity of mental health care in primary practice”.]

Improving the care of patients discharged following a pulmonary embolism, in line with NICE Guidelines (NG158).
[Shared learning from Nottingham Universities Hospitals Trust. Project started out as audit looking into how to improve discharge process for patients following a PE, however upon understanding limitations of care provided on discharge, practice was changed in line with NICE guidelines to ensure safest possible discharge for these patients.]

Risk factors for LGBTQ+ youth self-harm and suicide.
The Mental Elf; 2021.
[In her debut blog, Hazel Marzetti reviews a recent systematic review and meta-analysis on victimisation and mental illness prevalence among LGBTQ+ young people with experiences of self-harm and suicide.]

European Surveillance of Antimicrobial Consumption Network (ESAC-Net).
World Health Organization (WHO); 2021.
[The report found some differences in the use of antibiotics between two sets of countries, the ECDC’s European Surveillance of Antimicrobial Consumption Network (ESAC-Net) and WHO/Europe’s Antimicrobial Medicines Consumption (AMC) Network. Findings show a significant decrease in the consumption of antibacterials in eight ESAC-Net countries including the United Kingdom. However, figures for the AMC Network were less clear, reflecting the more complicated nature of data collection.]

Transition to adulthood and transfer to adult care of adolescents with congenital heart disease: a global consensus statement.
Moons P. European Heart Journal 2021;:ehab388.
[This consensus document describes issues and practices of transition and transfer of adolescents with CHD. Transitional care ought to be provided to all adolescents with CHD, taking into consideration the available resources. When reaching adulthood, patients ought to be transferred to adult care facilities capable of managing their needs, and systems have to be in place to ensure continuity of high-quality care.]

Children and young people’s mental health – policy, CAMHS services, funding and education.
House of Commons Library; 2021.
[Research briefing on children and young people’s mental health policy, June 2021.]

Community mental health and wellbeing : what does gold standard look like?
Digital Health & Care Innovation Centre, Scotland; 2021.
[Following interviews and meetings with key stakeholders a range of tools were developed to support collaborative discussion around gold standard community mental health and wellbeing, key relationships and challenges to implementation. This report presents findings of the resulting workshop.]

Emerging lessons from the commissioning and delivery of a gambling treatment service.
Woodall J. Public Health 2021;196:69-73.
[This article offers a unique contribution to understanding more about the provision of gambling treatment services. This is crucial, given that a greater number of people face challenges as a consequence of gambling harms, and such services should be seen part of forming a coherent public health response.]

PHE women’s reproductive health programme 2020 to 2021.
Public Health England (PHE); 2021.
[Progress update on the PHE reproductive health programme, including a new return on investment tool and the next steps for 2021 to 2022. Use these documents and tools to understand how this programme integrates with the upcoming women’s and sexual and reproductive health strategies. Links to new tools, publications and examples of best practice can also be used as a reference point for colleagues across the healthcare system, to inform prioritisation and planning.]

National flu immunisation programme plan.
Department of Health and Social Care (DHSC); 2021.
[The annual flu letter for 2021 to 2022 describes the national flu immunisation programme and outlines which groups are eligible for flu vaccination.]

Life Sciences Vision.
Department for Business, Energy & Industrial Strategy; 2021.
[This document outlines the government’s and the life science sector’s ambitions for the sector over the next decade. It sets out the government’s plans to stimulate a thriving UK life sciences sector. It also focuses on how the sector can address some of the UK’s most significant health care challenges, including cancer, dementia and obesity.]

Alcohol consumption and harm during the COVID-19 pandemic.
Public Health England (PHE); 2021.
[A report collating data on alcohol consumption and alcohol-related harm in England during the COVID-19 pandemic and comparing it to data from previous years. The report improves our understanding of how alcohol consumption and harm changed in England while physical and social restrictions to prevent and control coronavirus were in place. The findings help to understand whether pandemic-related changes have affected rates of alcohol hospital admissions and deaths as well as health inequalities.]

Early evaluation of the Children and Young People’s Mental Health Trailblazer programme.
University of Birmingham; 2021.
[The programme was launched in December 2018 to improve the prevention of mental health problems and early intervention for children and young people with mild to moderate mental health problems. The early evaluation is following the experiences of the initial group of mental health support teams, which are based in 25 areas across England (called Trailblazers) and work with more than 1,000 schools and colleges.]

Speeding up the diagnosis of deadly diseases

A boost in funding for artificial intelligence (AI) for the NHS

The Government is committed to saving more lives and detect up to three quarters of all cancers at an early stage by 2028. A £50 million funding investment has been made for work involving Digital Pathology and Imaging Artificial Intelligence Centres of Excellence with the aim to improve the diagnosis of diseases such as cancer.

The 3 centres identified to access a share of the funding include London, Coventry and Leeds, benefiting 26.5 million patients across the UK.

National Pathology Imaging Co-operative Director and Consultant Pathologist at Leeds Teaching Hospitals NHS Trust Darren Treanor said:

“This investment will allow us to use digital pathology to diagnose cancer at 21 NHS trusts in the north, serving a population of 6 million people. We will also build a national network spanning another 25 hospitals in England, allowing doctors to get expert second opinions in rare cancers, such as childhood tumours, more rapidly. This funding puts the NHS in a strong position to be a global leader in the use of artificial intelligence in the diagnosis of disease.”

To find out more click here.

Top tips for telephone triage and video consulting

Resources to support your practice

Total triage is important to reduce avoidable footfall in practices and reduce the risk and spread of infection. How to establish a remote total triage model in GP using online consultations available here.

Support for telephone and video consulting, GP’s, dentists, mental heath patients and cancer patients can be accessed here.

Royal Marsden Access

Difficulties accessing the resource

We have been made aware that some members of the trust are having difficulty accessing Royal Marsden online. We are working towards getting this issue resolved and will inform you of updates when this issue has been rectified.

You can still access the latest materials, however you will need to login via Athens. Follow these simple steps:

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  • Click on Wiley Royal Marsden Manual 10 (last on the list)
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