A data-driven approach to personalised cancer care

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One of the NHS’s greatest strengths is its comprehensive datasets of the population from birth to death. The new model of cancer care proposed in this paper looks at how data could be examined and used at every stage of the treatment journey, from prevention and diagnosis through to treatment and recovery. Making better use of data will not only improve cancer outcomes but will also enable the NHS to manage the disease far more effectively, now, and in the future. This paper is sponsored by AbbVie.

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The game changer: getting data right

There is a plethora of different datasets in cancer care including information on diagnosis, treatment, outcomes and patient experience, and multiple data flows between different organisations. However, Reform research has shown that the quantity of data has created a confusing landscape and even with all these different datasets some information for patient care is missing.

The cancer dashboard, currently run by Public Health England, is an online interface for all cancer related information. Going forward, the dashboard should be extended to become the single point of access for cancer outcomes data in England. In time, the dashboard could make the most of advancements being made in initiatives such as the 100,000 Genome Project, so it can provide accessible information to clinicians and patients on genetic risk to cancer. This will be dependent on a secure storage system and patient consent. It should also incorporate data generated outside of the traditional in-patient setting to provide a much richer picture of patient experience.

Alongside an improved cancer dashboard, data must be shared effectively and promptly between different stakeholders to ensure patients have the best possible care experience. This is especially important in cancer care as a patient normally interacts with many different parts of the health service. The local Cancer Alliances are best placed to drive improvements in data sharing and can look to examples like Greater Manchester, which has established a software system to allow for the secure exchange of information.

Putting the model into practice

An improved cancer dashboard provides the opportunity for the NHS to become better at preventing people from developing cancer. Almost 40 per cent of all cancer cases in England are caused by preventable factors such as obesity and smoking. GPs can use insight from the cancer dashboard on lifestyle and genetics to help those at risk of developing the disease make healthier lifestyle choices. This information will mean the NHS can encourage those at risk of developing the disease to attend a screening, to bring about earlier diagnosis of the disease.

Linking the dashboard with the 100,000 Genome Project can encourage a greater use of personalised medicine, targeted at the genetic profile of a patient’s tumour. One current trial of personalised medicine hopes to save 7,000 women with breast cancer the toxic-side effects of chemotherapy, by using genetic profiling to decide who can receive the new drug Herceptin.

A data-driven model can also do much more to prevent cancer returning after remission. Studies have looked at how exercise and diet can influence recovery. Apps and wearables can be used to support this.

Commenting on the report Cally Palmer, National Director for Cancer at NHS England, said: “Making the best use of data is really important for the current NHS Cancer Strategy. That is why, in addition to the dashboard, we have already introduced a new data service for cancer alliances for the first time – bringing together data on screening, diagnosis, treatment and patient experience.

“Alongside this report, we have also received a number of proposals for taking this work forward through the long-term plan and look forward to exploring some of these ideas.”

Key takeaways:

• The cancer dashboard, set up by Public Health England for the 2015 Cancer Strategy, should be extended and become the single point of access for cancer outcomes data.
• Dependent on a secure data storage system and patient consent, the dashboard could be linked to other datasets such as treatment i or genetic information, to provide a much richer picture of cancer causes and outcomes.
• The local Cancer Alliances should drive improvements in data sharing. The long-term plan for the NHS should ensure local areas have adequate support and funding to do this.
• Greater insight from an improved cancer dashboard should mean GPs have the insight to work with population groups at risk of developing the disease. GPs could use new models of care, such as social prescribing, to encourage people to make healthier lifestyle choices.
• Linking the outcomes data with initiatives such as the 100,000 Genome Projects provides the opportunity for far greater use of personalised medicine. Given that much of this new medicine can be administered out of the traditional in-patient setting, patients should have choice over how they wish to receive it.
• The local Cancer Alliances should use improved data collection to decide what treatment is most effective for their local populations. They should also be empowered to use real-world evidence to pay for medicines based on outcomes, as Greater Manchester is currently trialling.