Slide 1 Vicki Newport RGN BSc Midwifery BSc

Slide 1 Vicki Newport RGN BSc Midwifery BSc Advanced Nurse Primary Care Queen’s Nurse Macmillan Lead Improvement Nurse in London Cancer

Slide 2 Present Situation • Late detection of cancer diagnosis in A&E is still a problem – 23% patients in London diagnosed. • Poor one year survival late diagnosis. • Poor coverage and uptake of screening programmes in London- on average about 69% • Poor professional and patient awareness early cancer symptoms.

Slide 3 My role… Nurse Improvement Lead, London Cancer To improve the outcomes of early cancer diagnosis and awareness of cancer symptoms. To enhanced the capability of practice nurses in quality improvement in Primary Care ie safety netting/audit.

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Slide 7 Cervical Screening Leaflets

Slide 8 Cervical Smear Why do we over cervical screening?

Slide 9 Introduction . A cervical screening test (previously known as a smear test) is a method of detecting abnormal cells on the cervix- the entrance to the vagina. Detecting and removing abnormal cervical cells can prevent cervical cancer. Cervical screening is not a test for cancer; it is a test to check the health of the cells of the cervix. Around 1 in 20 women the test will show some abnormal changes in the cells of the cervix. Most changes will not lead to cervical cancer and the cells may go back to normal on their own but the abnormal cells need to be removed so that they cannot become cancerous.

Slide 10 What do you tell the patient? The cervical screening test usually takes a few minutes. . An instrument called a speculum will be gently inserted into your vagina to hold the walls of your vagina open so that your cervix is visible. A small soft brush will be used to take some cells from the surface of your cervix. The sample of cervical cells will then be sent to a laboratory and examined under a microscope to see whethere any abnormal cells. Some women may find the procedure a bit uncomfortable or embarrassing, but for most women it is not painful. If the test picks up abnormalities in the cells in your cervix, it may be recommended that you have treatment to remove them, or further tests in a few months to see if they return to normal on their own.

Slide 11 What early cancer symptoms am I looking out for? Usually no symptoms with abnormal cervical cells and sometimes there are no symptoms with early stage cervical cancer. Recognised symptoms associated with cervical cancer. • Abnormal bleeding: during or after sexual intercourse, or between periods • Post menopausal bleeding, if you are not on HRT or have stopped it for six weeks • Unusual and/or unpleasant vaginal discharge • Discomfort or pain during sex • Lower back pain

Slide 12 Preventing cervical cancer There is no single way to completely prevent cervical cancer, but there a number of things that can help reduce your risk. Safer sex- Most cases of cervical cancer are linked to an infection with certain types of human papillomavirus (HPV). HPV can be spread through unprotected sex, so using a condom can help reduce your risk of developing the infection. Cervical screening- Regular cervical screening is the best way to identify abnormal changes in the cells of the cervix at an early stage. Women aged 25 to 49 years old are invited for smear tests every three years. Women aged 50 to 64 years old are invited every five years. Smoking- offer and refer for smoking cessation advice.

Slide 13 NHS Cervical Screening Programme

Slide 14 Top 10 cancer killers • Lung • Pancreatic • Colorectal • Stomach • Breast • Non-Hodgkin’s lymphoma • Prostate • Ovarian • Oesophageal • Leukaemia

Slide 15 Gynaecological cancer 13 www. nice. org. uk/CG 027 quickrefguide

Slide 16 Quality Improvement • NHS strives to provide safe and good quality health care; improve patient experience, tackle effectiveness and update practice in the light of evidence from research. • Patient safety is identified in the NMC Code (Nursing and Midwifery Council 2008) and the RCN Principles of Nursing Practice (RCN 2010 a) as an essential part of nursing care. • Principle C states: "Nurses and nursing staff manage risk, are vigilant about risk, and help to keep everyone safe in the places they receive health care" (RCN 2010 b, Principle C).

Slide 17 Breast Screening

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Slide 19 Breast symptoms to look out for • A lump or thickening in an area of the breast • A change in the size or shape of a breast • Dimpling of the skin • A change in the shape of your nipple • A blood stained discharge from the nipple • A rash on a nipple or surrounding area • A swelling or lump in your armpit

Slide 20 Health Promotion • Physical exercise • Smoking • Alcohol • Diet • Lifestyle- being aware- any noted changes

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Slide 23 Macmillan Cancer Support

Slide 24 NHS Cervical Screening Programme- useful links http: //www. cancerscreening. nhs. uk/cervical/ http: //www. jostrust. org. uk/ http: //www. macmillan. org. uk/Home. aspx http: //www. nhs. uk/Conditions/Cervical-screeningtest/Pages/Introduction. aspx

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