Cancer
It is estimated that one in two people will develop cancer in their lifetime. Between 2011 and 2021, cancer incidence has risen in Scotland, however the age-adjusted mortality rate has fallen. Much of this can be explained by our ageing population and the fact that cancer is a relatively common disease among the elderly.
Cancer remains a national clinical priority for us and NHS Scotland. With effective population-based screening programmes, earlier detection, better diagnostic methods and advances in treatments, more people in Scotland are surviving cancer than ever before.
Cancer strategy and action plan
In June 2023, we published our Cancer strategy for Scotland 2023-2033 along with an initial three year Cancer action plan for Scotland 2023–2026.
Over the 10 years between 2023 and 2033, our strategic aim is to improve cancer survival and provide excellent, equitably accessible care. This will improve the experience of, and outcomes for, people affected by cancer in Scotland.
Our overall vision is that ‘more cancers are prevented; our compassionate and consistent cancer service provides excellent treatment and support throughout the cancer journey and improves outcomes and survival for people with cancer’.
The strategy and plan take a comprehensive approach to improving patient pathways from prevention and diagnosis through to treatment and post-treatment care.
We have outlined 11 ambitions and will work to deliver seven outcomes for cancer in Scotland:
- reduced relative population burden of disease
- reduced later stage diagnosis
- timely access to treatment
- more people receiving curative treatment
- improved experience of services, across all areas of care
- optimised quality of life for each individual
- embedded research, innovation and data capture in all services
We are taking forward 136 actions in the first three years of the strategy (from 2023 to 2026), through our initial action plan. These will provide the foundation to put into place new, better and sustainable ways to deliver cancer services across Scotland.
Our monitoring and evaluation framework (August 2023) outlines our intent to monitor and evaluate the cancer strategy for Scotland 2023 to 2033 and cancer action plan 2023 to 2026. It sets out a strategic, evidence-based and outcomes-focused approach to assess progress towards the vision of improved survival and excellent, equitably accessible care.
The Cancer action plan progress report 1: June 2023 – March 2024 (July 2024), details progress to date of actions in the initial three year cancer action plan.
The Scottish Cancer Strategic Board
We commissioned The Scottish Cancer Strategic Board to provide national oversight of the cancer strategy and associated action plans. It also provides oversight to national cancer governance groups and advises on clinical prioritisation within cancer services.
Detect Cancer Early (DCE)
We launched the Detect Cancer Early Programme in February 2012 with the aim to increase the proportion of breast, bowel and lung cancers detected at Stage I by 25%, with a focus on reducing health inequalities.
The Programme takes a whole-systems approach to early detection and encompasses primary care, secondary care, public education, data, innovation and screening.
To coincide with the development of Scotland’s ten-year cancer strategy in 2023, we developed a new early diagnosis vision in collaboration with the Centre for Sustainable Delivery (CfSD), helping to shape the future of the Detect Cancer Earlier (DCE) Programme. We carried out extensive engagement and consultation with key stakeholders across NHS Scotland, academia, third sector and patient groups to help shape the new strategy. This engagement led to the conclusion that the DCE Programme should now take an all-cancer approach to reducing later stage disease, with a continued focus on reducing health inequalities.
The vision is to reduce later stage disease by 18 percentage points with fewer people from more deprived areas being diagnosed at stages three and four.
Our 10 year earlier and faster diagnosis vision will be achieved through a number of workstreams:
- improving public education and empowerment
- supporting primary care
- optimising screening
- enhancing diagnostics
- harnessing data
- investing in Innovation
- diagnosing faster
Latest cancer staging data is on Public Health Scotland’s website. Detect Cancer Earlier's website - Get Checked Early - provides information about possible signs and symptoms of cancer and screening programmes as well as early detection stories.
Earlier Cancer Diagnosis Programme Board
In spring 2022 the DCE Programme Board became the Earlier Cancer Diagnosis Programme Board and is managed via the Cancer Improvement and Earlier Diagnosis Team in the Centre for Sustainable Delivery (CfSD). The multi-disciplinary group meets once a quarter with progress updates shared regularly with the CfSD Strategy Board and Scottish Cancer Strategic Board.
CfSD’s Earlier Cancer Diagnosis Programme Board is responsible for supporting and maintaining oversight of the delivery of the new earlier diagnosis vision and accompanying three year action plan.
Cancer waiting times (CWT)
Since 2001, our position on waiting times has been to focus on ‘whole cancer pathway’ standards. There are two waiting times standards which are applicable to adults (NHS Scotland patients over 16 at the date of diagnosis), with a newly diagnosed primary cancer against the ten major cancer types:
- 31-day standard from decision to treat until first treatment, regardless of the route of referral
The 31-day standard states that 95% of eligible patients should wait no longer than 31 days from decision to treat to first cancer treatment.
- 62-day standard from urgent referral with suspicion of cancer, including referrals from national cancer screening programmes and A&E, until first treatment
The 62-day standard states that 95% of eligible patients should wait no longer than 62 days from urgent suspicion of cancer referral to first cancer treatment.
For patients with cancer, our waiting times policy applies to first treatments. The first treatment standards provide assurance to patients that the immediate cancer control measures are being started as soon as possible and reduce the period of uncertainty whilst awaiting clarification of a diagnosis.
Patients are excluded from the standard who have died before treatment, refused all treatment or are regarded as clinically complex. On reflection of a whole patient pathway there may be some areas of delay not attributable to a NHS board’s performance - these pathways may be adjusted to discount periods of patient unavailability, for patient-induced delays and/or medical suspensions.
Cancer Waiting Times across NHS Scotland are published every quarter on the Public Health Scotland website.
Cancer waiting times: clinical review
We published a clinical review of cancer waiting times (CWT) standards in Scotland in May 2018 which provides a series of steps towards improving cancer pathways and patient experience in NHS Scotland. Our Cancer action plan for Scotland 2023 to 2026 includes a commitment to carry out another clinically led review of latest data and evidence by 2026. This will determine whether there is merit in specific additional or alternative cancer waiting times standards for different types of cancer and cancer treatment.
Cancer Performance and Delivery Board
The Cancer Performance and Delivery Board has a focus on NHS health board challenges, directing emphasis towards improvements and maximising opportunities. This focus ensures people referred with urgent suspicion of cancer (USC) are diagnosed and treated as quickly as possible.
Referral guidelines
We published updated Scottish referral guidelines (SRG) for suspected cancer (January 2019) to support primary care clinicians to identify those with symptoms suspicious of cancer.
These are also available as a quick reference guide.
We are updating these guidelines to help ensure the right person is on the right pathway at the right time. These are due to be published in spring 2025.
Screening
Information about screening tests in Scotland is available on the NHS Inform website
Cancer strategy for children and young people
In September 2021, we published the cancer strategy for children and young people. We worked with the Managed Service Network for Children and Young People with cancer (MSN-CYPC) to develop the strategy, setting out our ambitions for five years.
More information
You can find out about identifying, treating and managing cancers on the NHS inform website.
Contact information
Email: CancerPolicyTeam@gov.scot