Understanding decisions about early cancer diagnosis interventions

What is the issue?

Cancer survival and mortality are worse in the UK than in some other high-income countries. An important way to improve cancer survival is to increase the proportion of cases that are diagnosed early, as earlier treatment is likely to be more successful.

To support interventions to improve early diagnosis, decisions need to be taken in the NHS about whether investments are to be made and which ones, in the context of other demands on funds. In light of this, Cancer Research UK wished to understand how it might support local decisions to implement early diagnosis measures.

How did we help?

RAND Europe was commissioned by Cancer Research UK to help them understand how decisions are made at a local level (in England and Northern Ireland) about early diagnosis interventions for cancer. The study explored not only how these decisions are made, but also the evidence and tools that are used to support those decisions, how effective these resources are and what new updates, evidence and tools would be most useful in this space.

The study approach was qualitative, centred on an extensive programme of interviews with stakeholders.

Findings from the study will help to inform Cancer Research UK’s work to support early cancer diagnosis locally, thereby improving cancer outcomes.

What did we learn?

• The desire for more and better evidence to steer decision-making about investments in early cancer diagnosis in England and Northern Ireland was universal among the health service stakeholders interviewed.
• In England, the need to achieve the target of 75 per cent target of cancer diagnoses to be at Stages I and II by 2028 – as set out in the NHS Long Term Plan – has strengthened the desire for evidence among Cancer Alliances, especially on how best to achieve that level of improvement in practice.
• Data analytical capacity varies considerably across Cancer Alliances.
• In Northern Ireland, the process of developing a new cancer strategy is focusing attention on how to improve cancer survival, and has stimulated new data analysis on pathways to cancer diagnosis and treatment.
• Ideas for how Cancer Research UK might continue to support Cancer Alliances with improving early diagnosis included:
  • Shaping national guidance and influencing policymakers
  • Providing information/analyses
  • Providing, or helping Cancer Alliances to develop, more data-analytic capacity locally
  • Facilitating more primary care involvement in Cancer Alliances
  • Assisting with horizon-scanning for innovations
  • Linking researchers and innovators to NHS commissioners and providers of cancer services
  • Better coverage of the National Cancer Diagnosis Audit (NCDA).

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Read the full study