Cancer Prevention, Screening and Treatment: Current Activity and Services

Primary Prevention
Prevention remains the best form of tackling cancer, reducing the human suffering caused by the disease and improving outcomes. There is also a strong economic case for investing more in prevention, therefore reducing the pressure on services in the long term.

Reducing smoking prevalence
Smoking is the single largest preventable risk factor for cancer. The key actions of the Lewisham Tobacco Control Plan are:

  • Reducing availability to children - vending machines/supply of tobacco to minors
  • Reducing attractiveness of tobacco products - removal of display/reducing promotion/limiting exposure to tobacco use in media/reducing promotion through tobacco accessories
  • Taking action on illicit tobacco
  • Counterfeit Tobacco Seizures
  • NHS intervention- Stop Smoking services
  • Smoking and Pregnancy

Healthier nutrition /increasing physical activity

The evidence linking poor diet and obesity to cancer has become much stronger. In Lewisham there is a Promoting Health Weight for Lewisham Children, Young People and their Families Strategy and an action plan. The action plan includes the following:

  • Promotion of Healthy Weight for all children, including measuring of children in R and year 6, linking with schools nurses, Maternity, Early years, schools (linking with Healthy Schools)
  • Leisure Sports and Environment- including the promotion of free swimming, and the adoption of Change for Life to promote local activities and projects, the development of a Physical Activity Strategy and action plan in 2010.
  • Lewisham Food Strategy, which includes improving food access through the development of Food Co-ops, food growing through Community gardens and allotments , Schools Food Policy and Schools meals
  • Workforce training and communications
  • Development of targeted and specialist weight management services for children and adults


Excessive alcohol consumption is strongly linked to an increased risk of several cancers. Lewisham has published an Alcohol Strategy 2009-2012. The strategy aims to promote sensible drinking and to reduce the impact of alcohol misuse. Priorities for the coming year include the revision and development of the Council and PCT’s workplace alcohol polices, to run seasonal campaigns, to continue and develop the primary care based Directed and Local Enhanced Services and to develop an alcohol prevention pathway as part of the Health Checks programme.

Skin Campaign
The skin campaign was launched in April 2009 and ran until September 2009 across the six boroughs covered by the South East London Cancer Network. The campaign used innovative evidence-based social marketing techniques to produce measured behaviour change amongst residents, who are most at risk of skin cancer. Three ‘behavioural’ groups were targeted using a range of communication channels including a bespoke website, nightclub posters and on-the-ground engagement, supplemented with an education programme. The budget for the research and campaign implementation was jointly funded by the South East London Cancer Network (SELCN) and six PCTs. The results showed that 22% of South East London residents had remembered seeing the campaign, and of those who had seen it 36% said they had taken action as a result, including checking their skin more often and using higher level sun protection.

Human Papilloma Virus (HPV) vaccination for cervical cancer
Vaccination now presents a further opportunity in cancer prevention, specifically for cervical cancer. The government has introduced a national vaccination programme for young girls against the human papillomavirus. This will protect against the strains of the virus which cause around seven out of ten cases of cervical cancer. In the academic year 2008-09 Lewisham achieved an uptake of 72.6%, lower than the national target of 80%.

Increasing awareness and earlier presentation
Healthy Communities Collaborative Cancer project

A two-year community-based cancer initiative was launched in Lewisham September 2008 and completed in September 2010 The Healthy Communities Collaborative aimed to raise awareness and promote the earlier presentation of cancer symptoms. The project was focusing on three wards in Lewisham that have high deprivation with, high mortality and poor survival rates for cancer. These are Evelyn, New Cross and Bellingham and it included working with fourteen general practices in these wards. The focus was on breast, bowel and lung cancer.

Earlier diagnosis - Increasing the coverage/uptake of cancer screening
A key objective for NHS Lewisham and partners in reducing health inequalities is to improve cervical, breast and bowel screening uptake. Central to this is the involvement of primary care to promote screening. A specification for cancer screening and primary care is being developed. Health Equity Audits are currently being carried out on the breast and cervical screening progrmammes to assess issues of access.

Cervical cancer screening
Uptake rates for cervical screening will be analyzed by practice and poor performing practices will be targeted with support and best practice shared.

Breast Screening
A breast screening action plan has been developed and submitted to the London Strategic Health Authority. Key actions to implement this include, validation of practice lists, supporting and involving primary care to promote breast cancer screening and awareness raising and health promotion activities to women in the community.

Bowel cancer
A health promotion specialist has been appointed in South East London by the Bowel Cancer Screening Programme to promote bowel cancer screening, to work closely with Primary Care Services and to develop strategies to increase the uptake rate. Southwark PCT has developed a ‘bowel screening action pack’ to raise awareness of the programme among GP practices which will be promoted in Lewisham. Training and health promotion sessions have been and will continue to be carried out for health and social care professionals and a wide range of community and voluntary groups in Lewisham. An application for NAEDI funding for South East London sector to develop an integrated programme of awareness raising of bowel cancer symptoms and the screening programme was submitted at end of April 2010 and was successful. A campaign to raise awareness of bowel cancer signs and symptoms in the members of the community most at risk and in selected GPs practices is being planned for summer of 2011.

Secondary and tertiary care services
NHS Lewisham commissions for its patients access to a comprehensive range of diagnostic and treatment services for cancer, including tertiary care, primarily provided in the SELCN area.

SELCN Strategic Commissioning Priorities for 2009-2013

  • Bring cancer mortality in line with National target of 20% reduction over 10 years
  • Increase levels of awareness of cancer and causes
  • Improve continuously towards meeting National Targets and increase coverage. Breast - 70% Minimum - 80% Target. Cervical - 80%. Reduce Delays in reporting cervical cancer to 2 weeks. Implement Bowel Cancer Screening programme including age extension
  • Undertake National Audit in Primary Care for all newly diagnosed patients with cancer
  • Implement National Chemotherapy and Radiotherapy Guidance to improve access to treatment
  • Reduce inpatient bed days for cancer patients and increase ambulatory care
  • Reconfigure services in South London Healthcare, UHL and AHSC to deliver safe services locally where possible and centralise where necessary
  • Establish clear arrangements for the commissioning and provision of NICE approved drugs
  • Transform the Cancer Network management into clearly focused support for commissioning







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