Routes to Diagnosis now includes 10 years’ worth of data, covering more than 3 million cancer cases, making it the most comprehensive dataset of its kind in the world.

The data shows a dramatic improvement in the way some cancers are being diagnosed across England, but also pinpoints areas where improvements could still be made.

Key findings from the latest Routes to Diagnosis data include:

• diagnoses from emergency presentations, where outcomes are the worst, have improved falling from 24% to 20% between 2006 to 2015
• diagnoses through urgent GP referrals – 2 week waits – have increased significantly from 25% in 2005 to 37% in 2015, meaning that around 110,000 cases are now diagnosed this way
• diagnoses of pancreatic cancer through emergency presentation – with the very worst outcomes – has fallen by 6%, a significant drop
• diagnoses of colorectal cancers through the national bowel screening programme – the route with the best survival rate – remain under 10%
• the number of cancer cases diagnosed in Accident and Emergency varies across the country , ranging from 8% of all cases in the Peninsular Cancer Alliance to 20% of all cases in the London Cancer Alliance – this is despite similar cancer incidence levels

This latest update includes a new interactive tool which, for the first time, shows trends in cancer diagnosis for 53 different types of cancer. By using the tool doctors and managers will be able to quickly and easily see the differences between cancers and understand where survival rates are improving.

Dr Jem Rashbass, Cancer Lead at Public Health England said:

Diagnosing cancer earlier is one of the most important ways to improve cancer survival and we know that those patients who have their cancer diagnosed as an emergency have poorer outcomes. In England we have pioneered the analysis of routes to diagnosis data which allows us to highlight where we are making an impact and where challenges still remain.

Health Minister Steve Brine said:

With cancer survival rates at a record high it’s imperative that we continue to see a greater awareness of the signs and symptoms of cancer.

These figures demonstrate that our healthcare professionals are making a real difference by giving patients quicker referrals so they can access the best treatment available.

Sir Harpal Kumar, Cancer Research UK’s chief executive, said:

The earlier cancer is detected, the greater the chance that treatment will be successful. This Routes to Diagnosis data is an invaluable tool to see how we can diagnose cancer earlier.

We’re pleased to see that the proportion of people who are diagnosed as an emergency has fallen, but with 40,000 cancers still diagnosed in A&E each year in England we know that more improvement is needed.

The main reason the number of cancer diagnoses are increasing is because people are living longer and risk is of developing cancer increases with age. Lifestyle factors, such as the increase in obesity over the last few decades have also contributed to the rise in cases.

Case study

Earlier diagnosis leads to more successful treatment, so this data also highlights the importance of our cancer screening programmes in detecting cancer early.

Julia was diagnosed with stage 2a cervical cancer after her GP quickly referred her as a 2 week wait following post-coital bleeding; however she knows that it would have been detected earlier if she had attended her routine cervical screening appointments.

Julia Tugwell, cervical cancer survivor said:

I believe that if a GP or other healthcare professional had questioned me directly about my lack of screening attendance, over many years, I would have been more likely to have attended.

The new data shows that 3-year survival for cervical cancer following a screening diagnosis is 95%, compared to 65% when picked up through the 2 week wait – when symptoms might indicate a later stage cancer.

Background

1. National Cancer Registration and Analysis Service (NCRAS) is part of Public Health England and works to drive improvements in standards of cancer care and clinical outcomes by improving and using the information collected about cancer patients for analysis, publication and research.
2. Routes to Diagnosis groups patients into 1 of 8 routes:

• screen detected
• emergency presentation
• 2 week wait
• GP referral
• other outpatient
• inpatient elective
• death certificate only
• unknown

Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. It does this through world-class science, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services. PHE is an operationally autonomous executive agency of the Department of Health. Twitter: @PHE_uk, Facebook: www.facebook.com/PublicHealthEngland.

Kier Construction Limited (KIER), and their sub-contractor BKP Waste Recycling Limited (BKP), were sentenced at Bournemouth Crown Court on 12 January 2018 after earlier pleading guilty to an offence under the Environmental Permitting (England and Wales) Regulations 2010.

Kier Construction was commissioned by The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust to carry out re-development work at Christchurch Hospital in February 2012. KIER appointed BKP Waste Recycling Limited to drain and remove oil from an oil supply line in the hospital grounds.

Oil escaped from a poorly-made connection in the oil supply pipework, which failed during routine testing of heating systems at the hospital in November 2014. The spillage polluted groundwater.

The case was bought by the Environment Agency at the end of a lengthy investigation that uncovered negligence on the part of both contractors.

Ian Withers of the Environment Agency said:

This pollution incident had the potential to cause serious harm to the environment and was entirely avoidable. The 2 companies failed to understand the extent of the work required and mitigate the risks. Construction companies must adhere to environmental permitting regulations to prevent their activities from affecting the local environment.

KIER was fined £100,000 with £30,301 costs for causing groundwater activity under regulation 38 (1) (a) of the Environmental Permitting (England and Wales) Regulations 2010. BKP was fined £10,200 for the same offence with £42,851 costs.

If you are concerned about pollution to water or land, contact our 24-hour incident line on 0800 807060.

Greg Henshaw, 35, has been fined £2,416 after being caught by an Environment Agency bailiff for multiple fishing offences, including obstructing a fishery bailiff and using an illegal bait at Ripple on the River Severn in Tewkesbury.

Henshaw was found guilty by Cheltenham Magistrates’ Court on Friday 12 January for 5 offences; using an unlicensed rod and line, failing to state his name and address when asked by a Water Bailiff, fishing for fresh water in the closed season, wilfully obstructing an officer on duty and illegally using hook and bait during the prohibited close season.

Henshaw, of Wychwood Crescent in Birmingham did not appear in court. In his absence magistrates found him guilty of all charges. For each charge he was given a fine of £440, totalling £2,200, and Henshaw was also ordered to pay £172.61 and a victim surcharge of £44.

Andrew Eardley of the Environment Agency said:

This penalty for 1 angler is amongst the highest I’ve ever seen, and it’s good to see that the courts take instances of obstruction against enforcement officers seriously and that offenders are prosecuted.

An annual fishing licence costs just £30, yet a small number of anglers continue to flout the law and risk prosecution for fishing without a licence. Fishing licence money is invested into England’s fisheries and rivers; improving the sport of angling. So it’s fellow anglers that being cheated by those who choose to fish without a licence.

Environment Agency officers are checking licences regularly throughout the year. A licence costs just £30 and now lasts for 12 months from the day you buy it.

Money from fishing licence sales is invested in England’s fisheries and is used to fund a wide range of projects to improve facilities for anglers including protecting stocks from illegal fishing, pollution and disease, restoring fish stocks through re-stocking, eradicating invasive species, and fish habitat improvements. Fishing licence money is also used to fund the Angling Trust to provide information about fishing, to encourage participation in the sport and to manage a voluntary bailiff scheme.

Children under 12 fish for free. Anyone aged 12 to 16 also fish for free, but do need to have a valid Environment Agency fishing licence. Anyone over 16 must pay for an Environment Agency fishing licence to fish for salmon, trout, freshwater fish, smelt or eel in England.

Anyone witnessing illegal fishing incidents in progress can report it directly to the Environment Agency hotline, 0800 80 70 60. Information on illegal fishing and environmental crime can also be reported anonymously to Crime stoppers on 0800 555 111.