Cancer strategy: consultation analysis

Question 8

We propose to look at Prevention in relation to risk factors for cancer that can be modified at the population level and at the individual level. We are considering, for example:

• alcohol minimum unit pricing,
• smoke-free zones,
• restricting promotion and advertising of foods high in fats, sugar and salt,
• mandatory calorie labelling,
• raising awareness of weight management services,
• healthy eating advice,
• smoke cessation services.

In your experience, what actions do you think would be most effective for helping to stop people getting cancer and reducing inequalities in cancer incidence?

Please focus your response on the prevention of cancer and inequalities in cancer incidence.

Please explain your answer and provide any additional suggestions.

There were two open-format sub-questions under this section:

• 216 responses to the first question ("In your experience, what actions do you think would be most effective for helping to stop people getting cancer, and reducing inequalities in cancer incidence?"): 138 from individuals and 78 from organisations.
• 119 responses to the second question ("Please explain your answer and provide any additional suggestions."): 61 from individuals and 58 from organisations.

Education and awareness

The most common theme identified regarded the need for education and awareness as preventative measures. Respondents most commonly felt that promotion of a healthy lifestyle and awareness of cancer symptoms and how to self-check would be important for preventing cancer.

"Education from childhood onwards. Create a culture that focuses on health and well-being." (Individual response)

"There must be a focus on raising awareness of the symptoms of secondary cancers (largely left to the third sector to do), so that people know the early warning signs to look out for. I had no idea of secondary breast cancer symptoms until I was admitted to A&E with suspected appendicitis and then told I had incurable stage 4 secondary breast cancer." (Individual response)

Respondents also stated that education should target children and begin within schools, common examples including teaching sun safety and how to cook healthy meals. Other respondents felt that a community-based approach for awareness campaigns would be beneficial and some suggested involving people from ethnic minority backgrounds and religious leaders.

Improving diet

The second most common theme related to the impact that diet can have on preventing cancer. Many respondents felt that access to healthy food was not adequate suggesting that fresh fruit and vegetables should not cost more than high sugar and high fat alternatives. They mentioned that this was especially true within areas of deprivation.

"When it comes to healthy eating, the proposals on advice, calorie labelling and restricting promotions and advertisings are welcome but actually do not address the core problem, which is that healthy food costs more. […]" (Organisation response)

Specific initiatives relating to diet that were frequently commented on included the need for school- and community-based cooking classes, but many respondents expressed concerns that the proposed mandatory calorie labelling would be detrimental for those with eating disorders.

"[…] Calorie labelling can be useful but I feel like it can feed into eating disorders, with calorie counting. I'd like to see labelling making the main focus on nutrition and protein e.g. how many of your 5 a day, how much protein does it contain, percentage of vitamins. […]" (Individual response)

Tackling socio-economic inequalities

Another significant theme found within the responses includes the need to tackle inequalities with a particular focus on socio-economic deprivation. Many respondents expressed the view that socio-economic deprivation is often the root cause of other risk factors for cancer. They provided examples such as lack of access to healthy food, green spaces and exercise facilities, and poor-quality housing.

"Many of the risk factors associated with the incidence of cancer are directly related to poverty and deprivation - the above are useful but of limited benefit on their own. More should be outlined about how to address some of the root causes and issues people face, particularly those on low incomes with poor housing and poor health outcomes." (Individual response)

Respondents also called for financial support to be made available to those from deprived socio-economic backgrounds when going through their cancer journey.

"Financial support for people living with and affected by cancer. This is a key concern of patients with a cancer diagnosis, how will I pay my mortgage etc. […]" (Organisation response)

Preventing smoking

Lastly, the theme of preventing smoking was common within the responses to this question. Respondents particularly felt that smoking cessation services were an asset within cancer prevention, and they called for more funding into these services to keep them open, increase their number throughout the country, and improve awareness, access and engagement.

"[…] Smoking cessation services need to be widespread and promoted and easily accessible to all. This should not require a GP appointment or referral. […]" (Organisation response)

Many respondents also noted that the cancer strategy should specifically include vaping as well. Respondents suggested that it would be most beneficial to target preventative measures for vaping at teenagers and young adults.

"[…] Much more needs to be done to educate children and young adults about the dangers of smoking and vaping. There needs to be a bigger emphasis on smoking cessation measures. And the availability of cigarettes needs to be curtailed further." (Individual response)