Cancer Reform Strategy - NHS Cancer Screening Programmes

CHAPTER 2: PREVENTING CANCER 412.50 Seven pilot sites were established as partof the programme, each testing different modelsof delivering a cancer genetics service. Althoughthe pilot sites operated their service in differentways for the benefit of their local populations,the core of each service consisted of thefollowing:●●●●Promotion of the service;Access to the service (self- or primary carereferral);Assessment of patients; andClassification of patients into high, moderateand general population risk, with clearpathways for each.2.51 The range of service models exploredincluded services targeted for specific ethnicminority populations, lower-socioeconomicgroups and rural communities. They alsoinvolved a range of health professionalsincluding primary care nurses, outreach geneticscounselling from the genetics specialist service,GPs with special interests and cancer specialistnurses.2.52 The pilots came to an end during 2007and are being evaluated by a team at theUniversity of Nottingham. If the pilots are shownto be effective, evidence based advice to theNHS will be developed on how best to set upand run familial genetics services. This advicewill be closely linked with the fullimplementation of the NICE Familial BreastCancer Guidance. Most of the pilot sites havealready been successful in securing futurefunding to continue their service from localcommissioners.2.53 We want people who are concernedabout their family history of cancer to haveaccess to cancer genetic services with highquality risk assessment and counsellingservices. Following evaluation, we willprovide guidance to commissioners on howto commission these services.2.54 The 2003 Genetics White Paperannounced an £18 million investment intechnology for NHS genetics laboratories toimprove the speed and accuracy of genetictesting.17 Now that the new equipment iscoming on stream, tests for cancer genes arebeing carried out more efficiently and mostpatients where the faulty gene in the family isknown are not having to wait so long beforeknowing their result. Innovations in technologywill make this testing even quicker and moreaccurate in future, but the complexity of thesetests and what they mean still needs theavailability of specialist genetic counsellors toprepare patients for testing and to explain theresults.Research in cancer prevention2.55 Several important initiatives are underwayto strengthen research in cancer prevention andbuild an evidence base to inform policy andsupport the implementation of effectiveinterventions to reduce cancer risk andencourage behaviour change.2.56 Following the publication of a report in2004, the National Cancer Research Institutebrought a consortium of research funderstogether to set up the National PreventionResearch Initiative (NPRI). The NPRI is a UK-wideinitiative made up of government bodies,research councils and major medical charitiesthat are working together to encourage andsupport research into chronic disease prevention,including cancer prevention. The NPRI is a multidisciplinaryinitiative, managed by the MedicalResearch Council, which recognises that diseaseprevention is a major research priority.2.57 NPRI funded studies are exploring a rangeof approaches to promoting positive healthbehaviour, to encourage people to avoid habitsthat increase their risk of cancer and to follow ahealthy diet and physical activity programme.Many are taking place in local settings – schools,neighbourhoods, homes, the workplace and GPsurgeries – with members of the communityhelping to develop and test new interventions.Some projects use the internet to influencehealth behaviour, develop partnerships withlocal food shops, train members of the