Cancer screening rates in Brent are falling behind the averages for both London and England, a recent Health and Wellbeing Board meeting heard.
The Cancer Health Needs Assessment presented to the board revealed that uptake for cervical, breast, and bowel cancer screenings in Brent is lower than the North West London and England averages. HPV vaccination rates have also seen a decline.
Mai Stafford, Head of Evidence & Insight in Public Health, highlighted that more deprived areas within Brent tend to have lower screening rates, and there are also ethnic variations in uptake. The assessment noted that prostate cancer incidence is higher in Black ethnic groups, with a concerning lack of awareness about its symptoms. Local qualitative research reveals a critical lack of awareness regarding prostate cancer symptoms and when/how to seek medical response among Black African and Black Caribbean residents. For head and neck cancer, incidence is disproportionately higher in men and individuals from South Asian ethnic groups, linked to smokeless tobacco use, which is highly prevalent among men and South Asian communities.
Brent is implementing localized outreach using Brent Health Matters
and MANVAN
(for prostate cancer screening for Black men), and utilizing community champions to tackle inequalities and extend reach. There are also targeted, personalized support programs for individuals in the CORE20 most deprived communities to access cancer prevention and early diagnosis through Brent Health Matters. Additionally, a non-responder cancer screening calling project
is in place for bowel cancer screening, and HPV self-sampling is being rolled out through primary care.
While Brent is moving towards more timely diagnostic pathways, which is hoped to improve survival rates, the board was urged to advocate for cancer prevention and early detection services. Brent is moving away from emergency diagnoses and towards more timely pathways through screening programmes and GP two-week waits. Diagnosis via national screening or GP referral leads to significantly more timely diagnosis and better treatment outcomes compared to emergency routes (e.g. A&E).
Ruth Du Plessis, Director of Public Health and Leisure, emphasised the need to keep cancer prevention a priority in the new Health and Wellbeing Strategy.
Councillor Johnson raised concerns about prostate cancer screening, particularly for Black men, and questioned whether national efforts were being made to implement a screening program for this demographic. Dr. Rammya Mathew, Vice Chair of the Health and Wellbeing Board and a GP, explained that a national review had decided against recommending prostate cancer screening as a national programme due to insufficient evidence, though he acknowledged the ongoing controversy. GPs are advising men that if you feel you have risk factors or if there's a family history or if you are just concerned, then do come forward
for prostate cancer checks.
Dr. Mathew suggested that Nothing preventing us from doing a pilot
for prostate cancer screening and that GPs are a lot more open to offering prostate cancer screening than we were a few years ago.
Councillor Rubin also proposed that a pilot for prostate cancer screening in Black men be considered and brought back for discussion. The Man Van
approach is described as an asset-based approach to prostate cancer screening for Black men.
Dr. Mathew also expressed concern about declining HPV vaccination rates, which are crucial for preventing cervical cancer. The decline is attributed to negativity against vaccines and a vaccine hesitancy,
often stemming from misinformation.
Strategies to address this include continuing to really engage with communities,
understanding the importance of vaccination through talking to wider family members and others,
and working with schools. The meeting also noted that HPV vaccination is primarily delivered in schools, not primary care, and there's a need to review the contract with Vaccination UK. He urged the board to consider how to engage young people and parents on this issue.
The assessment was presented to the Health and Wellbeing Board, details of which can be found in the Public reports pack and the Agenda frontsheet.
