Cancer Improvement and Earlier Diagnosis

The Centre for Sustainable Delivery (CfSD) works collaboratively with academics, wider UK nations, senior leaders, patient representatives, third sector, NHS Scotland’s clinical community and others to improve outcomes for Scotland’s cancer patients.

The CfSD Cancer Improvement and Earlier Diagnosis Team lead the Scottish Government’s flagship Detect Cancer Earlier Programme that aims to reduce later stage disease (stages III and IV) by 18 percentage points by 2033. The Programme has a focus on reducing the health inequality gap, particularly those from areas of deprivation.

This bold new vision for earlier diagnosis forms part of the Cancer Strategy for Scotland 2023 - 2033, published on 15 June 2023. The Cancer Improvement and Earlier Diagnosis Team (CI&ED) played an integral role in the development of the strategy, particularly the ‘earlier and faster’ chapter. The CI&ED team is responsible for delivering these actions in the Cancer Action Plan for Scotland 2023 - 2026.

To realise the earlier cancer diagnosis vision for Scotland, a whole-systems approach is required across the following areas:

• Improve Public Education and Empowerment: Raise awareness of possible signs, symptoms and risk factors of cancer to empower people to seek help in a timely manner.
• Support Primary Care: The vast majority of people with cancer will develop symptoms prior to diagnosis so it is imperative to continue to support primary care clinicians in identifying and appropriately referring those with a suspicion of cancer.
• Optimise Screening: While setting the screening agenda remains the responsibility of Scottish Government, it’s often the most effective way to find cancer early. The CI&ED team will continue to work with partners to raise awareness of the benefits and risks of screening and optimise screening programmes where possible.
• Enhance Diagnostics: The early diagnosis or exclusion of cancer is essential to reduce anxiety for people with cancer and their families as well as to guide clinical care. This requires timely access to the most appropriate and effective diagnostic tests, both in primary and secondary care. Further innovation and redesign of diagnostic services will be required to facilitate timely access to tests as they emerge. Meanwhile, work will continue with Boards to deliver Scotland’s Endoscopy & Urology Diagnostic Recovery & Renewal Plan (see more information below).
• Harness Data: Continuous improvement in the provision of timely, high-quality, transparent, and integrated data will enable an improved understanding of barriers to earlier diagnosis and variation (geographical, socio-economic, ethnicity and other equalities data).
• Invest in Innovation: Research and innovation have a key role to play in improving earlier diagnosis rates, such as biomarkers (including volatiles), artificial intelligence and multi-cancer early detection tests (MCEDs). This requires coordination across multiple partners, including industry and academia in close collaboration with CfSD’s Innovation Team.