THE number of people in Scotland diagnosed with less treatable late stage cancers will be cut by 5000 a year by 2033 under plans to improve early detection and survival.
The goal was set out as the Scottish Government published its new 10-year cancer strategy with a pledge to reduce incidence through "strong public health interventions", which may include a hike in the minimum price of alcohol.
The strategy, underpinned by a 136-point action plan, also signals a potential shift in waiting times targets, stating that a clinically led review of latest data and evidence will "determine whether there is merit in specific additional or alternative cancer waiting times standards for different types of cancer and cancer treatment".
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It comes after statistics revealed that fewer than 72 per cent of cancer patients in Scotland are starting treatment within 62 days of a referral for diagnostic tests and scans, the worst waiting times performance on record.
Dr Sorcha Hume, chair of the Scottish Cancer Coalition and Cancer Research UK's public affairs manager in Scotland, said the plan "has the potential to transform cancer services" if it is backed up by adequate investment.
She said: “If it is fully funded and implemented, the plan will help improve the way we diagnose, treat and care for cancer patients.
"It provides a pivotal opportunity to see Scotland’s cancer services change from world-lagging to world-leading."
However, Scottish Labour leader Anas Sarwar warned that the strategy gives "no indication" of when the 62-day waiting time target - which has been missed for over a decade already - will be met, adding that the action plan "doesn’t mention it at all".
Dr Sandesh Gulhane, a GP and Scottish Conservative health spokesman, also questioned why the strategy "mentions precious little about if and when these targets will ever be met".
Scotland's ageing population means that cancer incidence is projected to rise by nearly 20 per cent, to around 42,100 cases a year, by 2040.
On current NHS performance, around 42% of cancers are diagnosed at stages III or IV.
If the goals set out in its cancer strategy are realised, the Scottish Government said this would be cut to 24% by 2033, adding: "Based on the latest data available at the time of publication, this would mean around 5000 fewer people in Scotland diagnosed with later stage disease in year 10."
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The report said this could be achieved through a "redesign of diagnostic services" and the increased use of artificial intelligence, biomarkers and multi-cancer early detection tests that can scan the blood for traces of various types of cancer, as well as the rollout of targeted lung cancer screening for high risk adults aged 55 to 74.
The Government will also explore "the use of self-sampling for cervical screening", potentially enabling more women to use home testing kits instead of attending for smears.
By 2033, greater use of telemedicine means that patients will attend clinical settings "only where necessary", with the report pledging to focus on improved survival rates for cancer types with the "largest burden and worst outcomes" including lung, brain, liver, oesophagus, pancreas, and stomach.
Dawn Crosby, head of devolved nations at Pancreatic Cancer UK, said Scotland was "leading the way" but stressed that the promises must be "backed-up by targeted, sustained investment".
She said: "Until today, people with pancreatic cancer – half of whom currently die within three months of their diagnosis – had been ignored by government strategies and plans.
"And as a result, survival rates have barely changed in decades."
The report warns that an estimated 13,000 cancer cases a year - 40% of the total - could be prevented through behaviour and lifestyle changes.
It says incidence will be curbed by delivering on the goal of a tobacco-free Scotland by 2034 - equivalent to fewer than 5% of the population smoking.
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The strategy also promises action on obesity and alcohol consumption through "legislation to restrict promotions of less healthy food", consultation on alcohol advertising, discussions on calorie labelling for alcohol, and a "change in the unit price" for alcohol within the next three years subject to the results of an evaluation into minimum unit pricing (MUP) due later this month.
It comes despite criticism from health campaigners after First Minister Humza Yousaf shelved key public health policies, including plans to ban retailers from selling junk food in multibuy deals.
A consultation on more limited interventions will be launched later this year.
Mr Yousaf has also instructed officials to take proposals on alcohol marketing restrictions "back to the drawing board" following a backlash from businesses.
Health Secretary Michael Matheson, who launched the plan during a visit to the Cancer Centre at Western General Hospital in Edinburgh, insisted that the cancer strategy “takes a strong public health approach, which means more cancers will be prevented".
He added: "Those who require diagnostics and treatment will have prompt access to quality services.
"As well as being able to cure more people, we also recognise the importance of treatment to extend good quality life and the provision of excellent palliative care.”
Lorraine Dallas, chair of the Less Survivable Cancers Taskforce Scotland, said she was encouraged to see a "clear commitment" on earlier diagnosis and treatment for cancer types with the poorest survival.
“Those include cancers of the pancreas, lung, stomach, liver, brain and oesophagus (the less survivable cancers) which have an average five-year survival of just 16% from diagnosis.
"Lung cancer remains Scotland’s single biggest cause of cancer death and a continued focus and action to address this should be an urgent priority."
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