Cancer: policy context

Cancer remains one of Scotland’s single biggest health challenges, affecting every one of our citizens in some way throughout their lifetime. Cancers comprise the single largest cause of death in Scotland. However, about 40% of cancers could be prevented through modifiable lifestyle changes, with smoking and obesity having the largest preventive potential (Brown KF et al (2018)).

Although cancer survival continues to improve over time, outcomes in Scotland – as with the rest of the UK – remain poorer than in many developed countries (Arnold M et al (2019)). Public Health Scotland (PHS) participates in a number of international studies to better understand what can be done to further improve cancer outcomes. There is evidence that patients in the UK are diagnosed at a later stage of cancer than in other countries with better outcomes (Cabasag CJ et al (2020)), but this is not the only explanation for differences in survival. As more people survive from cancer, there is an increasing need to understand how to improve the lives of people living with, and beyond, the disease. PHS is involved in several pieces of work to better understand patients’ experiences, including through the Scottish Cancer Patient Experience Survey. Thus, PHS contributes to informing improvements in the primary, secondary and tertiary prevention of cancer.

Co-ordinated efforts to reduce mortality, morbidity and occurrence of cancer – cancer control – are usually set out in national cancer control plans. The Scottish Government launched its latest cancer strategy in June 2023 - Cancer Strategy for Scotland 2023-2033. This sets out how it intends to improve cancer services, care, treatment and overall survival over the next 10 years. Alongside the new cancer strategy is the Cancer Action Plan for Scotland 2023-2026, covering the first 3 years of the 10-year strategy. This sets out what the government is hoping to achieve by 2026. A Monitoring and Evaluation Framework was also developed in parallel with the cancer action plan to improve its effectiveness.

There are 11 priority areas that outline the ambitions of the cancer strategy. These can be categorised under two headings, ‘Pathway’ and ‘Cross-cutting'.

Pathway

  1. Preventing More Cancers.
  2. Earlier and Faster Diagnosis.
  3. Best Preparation for Treatment.
  4. Safe, Realistic and Effective Treatment.
  5. Excellent Care and Support After Treatment.

Cross-cutting

  1. Sustainable and Skilled Workforce.
  2. Person-Centred Care for All.
  3. Tackling Inequalities.
  4. Mental Health as Part of Basic Care.
  5. Flourishing Research and Innovation.
  6. Cancer Information and Intelligence Led Services.

The 2023 strategy was the first to dedicate a chapter to the role of cancer information and intelligence as essential parts of cancer control and it identified a number of specific objectives for PHS.