February: World Cancer Day | UK National Heart Month | Raynaud’s and Scleroderma Awareness Month

Innovative Trials are passionate about ensuring our diverse population is adequately represented within medical research. Whether it is wanting to see more people from underrepresented communities choosing science as a career and pushing for greater patient diversity in clinical trials or focusing on what we are doing internally to celebrate and promote equality and diversity.

Throughout 2021, we have made a pledge to share our education and experiences, to ensure inclusivity across the board. Each month, we will be releasing communications in line with national and international awareness campaigns.

Last month we looked at Women’s Health, which you can read here. This month we are looking at World Cancer Day, UK National Heart Month and Raynaud’s Scleroderma Awareness Month.

World Cancer Awareness

Cancer is a disease where abnormal cells divide without control causing tumours to form and can invade nearby tissues. The Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are more than 100 types of cancers.

On the 4th of February World Cancer Day is recognised to raise awareness of the disease and support cancer research.

Cancer Incidence:

  • There are around 367,000 new cancer cases in the UK every year, that’s around 1,000 every day (2015-2017).
  • In females in the UK, there were more than 179,000 new cancer cases in 2017.
  • In males in the UK, there were around 187,000 new cancer cases in 2017.
  • Every 2 minutes someone in the UK is diagnosed with cancer. 
  • Breast, prostate, lung and bowel account for 53% of all new cancer cases in the UK (2017).
  • Incidence rates for all cancers combined in the UK are highest in people aged 85 to 89 (2015-2017). 

More statistics can be found here.

 

Diversity and Inclusion in Cancer 

Did you know?

  • Black men are 3 times more likely to have prostate cancer compared to white men.
  • Death rates from prostate cancer are 30% higher in black men than in white men living in England. 
  • Asian people are between 1.5 and 3 times more likely to get liver cancer than the white population in England.
  • Black and Asian females aged 65+ are at a higher risk of cervical cancer than white females in England

 

‘There is a great need for more robust cancer data on ethnicity; as the quality of ethnicity recorded in routinely collected health data remains poor. This raises concerns around the completeness and accuracy of analysis when using existing data’ – Macmillan Charity

 

Innovative Trials are currently supporting a Phase 3 study in Metastatic Castration-Resistant Prostate Cancer. This study originally intended to have diversity outreach visits to sites. Due to site selection being based on Ethics Committee approvals, visits were only general community outreach and not diverse. As low as 0.8% African Americans were represented at one site, so efforts to deliver diversity outreach in future continues. 

The NHS and Cancer Research UK (CRUK) are developing new inclusion strategies of all ethnic communities in cancer studies. 

Some of CRUK’s key priorities include reducing cancer inequalities, developing a more diverse community for staff, volunteers and research and making information inclusive, relevant and accessible.

The NHS have released three short videos for Reducing inequalities in BME patient experience of cancer care regarding bias, communication and dignity.

 

UK National Heart Disease Awareness

Cardiovascular disease (CVD) is a general term for conditions affecting the heart or blood vessels. CVD includes all heart and circulatory diseases, including coronary heart disease, angina, heart attack, congenital heart disease, hypertension, stroke and vascular dementia. 

CVD Incidence:

  • This disease affects around 7 million people in the UK and is a significant cause of disability and death
  • It is responsible for 1 in 4 premature UK deaths and accounts for the largest gap in health life expectancy.
  • The most deprived 10% of the population are almost twice as likely to die as a result of CVD; than those in the least deprived 10% of the population
  • You are at high risk of having CVD if you have atrial fibrillation (AF), high blood pressure, or high cholesterol. 
  • Those who smoke or have diabetes, are at a greater risk of developing CVD. 
  • Also at risk are those with a family history of heart disease, or who are from a BAME background
  • There are significant health inequalities for people living with severe mental illness (SMI). Life expectancy is 15-20 years lower than the general population. People with SMI have a 53% higher risk of having CVD and 85% higher risk of death from CVD

Did you know? 

 

Diversity and Inclusion in Heart disease 

  • People with, or at risk of, developing CVD can improve their health and quality of life; by adopting healthy lifestyle habits and taking prescribed medication.
  • Large-scale European studies suggest that people have limited success in making lifestyle changes; to reduce coronary risk after a cardiac event (Pyorala et al., 2004). Moreover, adherence to prescribed medicines for those with established CVD is typically less than 50% (Kripalani et al., 2007). 
  • Structured cardiac rehabilitation is an effective way to support people with CVD to make the aforementioned changes; thereby reducing cardiac-related deaths (Jolliffe et al., 2001).
  • Uptake of cardiac rehabilitation, however, remains poor among women, older people and those from lower socio-economic groupings and minority ethnic communities. 
  • People who do not speak or understand English also face considerable difficulties due to the limited availability of interpreters. Access to culturally appropriate rehabilitation, therefore, remains a problem for many groups.

Prevention is at the heart of the NHS long term plan to tackle heart disease called CVDPREVENT to reduce obesity, alcohol and smoking.

 

Raynaud’s and Scleroderma Awareness

Scleroderma is an uncommon condition that results in hard, thickened areas of skin; and sometimes problems with internal organs and blood vessels. This is caused by the immune system attacking the connective tissue under the skin; and around internal organs and blood vessels. This causes scarring and thickening of the tissue in these areas.

There are 2 types of systemic sclerosis:

  • Limited cutaneous systemic sclerosis – a milder form that only affects skin on the hands, lower arms, feet, lower legs and face, although it can eventually affect the lungs and digestive system too. This can start as  Raynaud’s syndrome (a circulation problem where fingers and toes turn white in the cold). 
  • Diffuse systemic sclerosis – is more likely to affect internal organs such as the heart, lungs or kidneys. This can cause a range of potentially serious problems, such as shortness of breath, high blood pressure and pulmonary hypertension (high blood pressure in the lungs).

There’s no cure for scleroderma, but most people with the condition can lead a full, productive life. The symptoms of scleroderma can usually be controlled by a range of different treatments.

Scleroderma Incidence:

In the UK, scleroderma has an incidence rate of 4 cases per million per year; with a prevalence of 30 cases per million. All age groups may be affected, but it is common between 30 to 50 years of age.

Did you know? 

Prevention and Treatment

There are annual tests for scleroderma available including – pulmonary, cardiac, kidney, blood pressure and pain tests. Patients who have normal pulmonary function tests at the time of presentation are unlikely to develop severe Pulmonary Fibrosis. Renal disease usually occurs within the first five years of diagnosis. Adopting a multidisciplinary approach could provide patient education and a self-management plan. Patients should report any changes in their condition.  Self-help groups provide an invaluable source of support.

Treatment can include proton pump inhibitors and antibiotics. Prognosis is associated with the extent of skin and organ involvement. Young age, African-Caribbean ethnicity, anaemia, elevated ESR, pulmonary and renal involvement indicate a more severe prognosis. Survival rates over 10 years are 71% for Limited cutaneous systemic sclerosis, and 21% for Diffuse systemic sclerosis.

 

Conclusions

Raising awareness of these diseases empowers us to recognise any signs or symptoms early; and having accurate information can help us make informed decisions about our health.

 Early detection saves lives. A recent UK study found that for 8 common cancers – bladder, bowel, breast, cervical, womb, malignant melanoma, ovarian and testicular cancers – survival is 3 times higher when diagnosed early. 

‘This year’s World Cancer Day’s theme, ‘I Am and I Will’, is all about you and your commitment to act. We believe that through our positive actions, together we can reach the target of reducing the number of premature deaths from cancer and noncommunicable diseases by one third by 2030.’ #WorldCancerDay #IAmAndIWill

 

Equality, Diversity and Inclusion continues to be high on our agenda.  We are working behind the scenes to push this forward. Keep your eyes peeled for more.

Read our previous Awareness blog around Women’s Health here.

Find out how we’re working with clients to ensure greater patient diversity in clinical trials.

Request our latest Diversity Outreach Case Study