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** 16 August 2023
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** UK
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** Patients could get cancer scans without GP referral, says Steve Barclay (#1)
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** London: Free support offered to LGBTQ+ community to quit smoking (#2)
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** Wales: Pembrokeshire Trading Standards on illegal tobacco and vape sales (#3)
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** Scientists discover cause of smoking addiction (#4)
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** International
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** USA: How a simple blood test can help detect lung cancer earlier (#5)
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** UK
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** Patients could get cancer scans without GP referral, says Steve Barclay

Patients with cancer symptoms could bypass their GP in the future and go straight for a scan, the health secretary has suggested, in the latest “radical” attempt by the government to cut huge NHS waiting lists.

The suggestion, which comes as the government is expected to reduce the number of NHS cancer waiting time targets, could form part of proposals to “design out bottlenecks” in the NHS system, Steve Barclay said in an interview.

Health department officials are reportedly working on proposals that would mean some patients experiencing cancer symptoms could go straight to an NHS diagnostic centre – or “one-stop shop” – without a GP referral.

“We are very much looking at those patient pathways,” Barclay told the Daily Telegraph. “Where there are bottlenecks in the system of referral from the GP, is there scope to go direct to the relevant diagnostic test or to the clinician?

“Breast cancer is a good example because almost always the GP refers on … and therefore there’s an opportunity to design out bottlenecks in the system.”

The government has been consulting on measures to streamline NHS cancer care by replacing the nine existing cancer targets with just three and scrapping entirely the current target of all patients seeing a specialist within two weeks of an urgent referral for cancer tests by a GP.

Latest figures show that only 59% of patients in England started their first cancer treatment within two months of an urgent GP referral, far below the current 85% target set by the government.

Source: The Guardian, 15 August 2023
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** London: Free support offered to LGBTQ+ community to quit smoking

A hospital trust is teaming up with its local authority to offer free support for LGBTQ+ people to quit smoking after figures show the community has a disproportionately high number of smokers.

Guy’s and St Thomas’ Tobacco Dependence Treatment Service, is working with community arts partnership Art4Space and LGBTQ+ forum Lambeth Links to offer an 8-week programme to help LGBTQ+ people quit smoking.

The initiative comes following the latest Office fFor National Statistics data which shows the proportion of smokers is higher among people who identify as gay or lesbian than among heterosexual people.

Stop smoking advisors from Guy’s and St Thomas’ will help people attending these group sessions to identify smoking triggers, such as stress and social situations, and to learn how to manage these.

The team will also offer free nicotine replacement products such as patches and chewing gum that may help with cravings.

Oscar Moreno, Tobacco Dependence Treatment Manager at Guy’s and St Thomas’, said: “Our team are here to support people to reach their goal of quitting smoking for good, by providing treatments that can help beat cravings and giving motivational tips so they keep on track.

“These groups can create a real sense of belonging and offer a fantastic opportunity to support each other, from setting a shared quit date to supporting each other on their quitting smoking journey through their weekly sessions.”

Source: London News Online, 15 August 2023
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** Wales: Pembrokeshire Trading Standards on illegal tobacco and vape sales

Cracking down on illegal tobacco products and vapes is “a priority” for Trading Standards in Pembrokeshire, as new figures on seizures have been released.

Since 2016, 100 illegal cigarette packs have been seized in Pembrokeshire, while 100 illicit tobacco products have also been seized.

Across Wales, 20,938 illegal vapes have been seized – all since 2021, as well as 388,669 illegal cigarettes and 53,970 illegal tobacco products – both since 2011.

A survey by the non-profit group Action on Smoking and Health Wales (ASH Wales) found that the illegal tobacco market makes up 15 per cent of all tobacco sales in Wales, with a higher prevalence in deprived communities.

“Illegal tobacco has been known to have links with serious organised crime,” read an ASH Wales statement. “Selling illegal tobacco may initially seem straight-forward, but if you look past the sellers and look further up the production chain, there is scope to fund serious criminal activity.

“It’s a gateway for children. Sellers often target children by selling cigarettes individually and/or at cheap prices.

“All tobacco is harmful, but illegal tobacco makes it easier for children to start smoking. Sellers rarely care who they sell to and can play a big part in starting a life-long addiction.

“Finally, cheap prices and the lack of health warnings do not help smokers to quit.”
Trading Standards Wales recently announced that officers had been given greater powers as new sanctions came in to force to combat the sale of illegal tobacco.

As of July, businesses and individuals selling illicit tobacco can receive a penalty of up to £10,000, while Trading Standards officers now have the power to refer cases to HMRC for further investigation. HMRC, where appropriate, will issue penalties and sanctions.

Source: Western Telegraph, 15 August 2023

See also: ASH Wales – Illegal Tobacco ([link removed])
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** Scientists discover cause of smoking addiction

Smoking is the single biggest cause of cancer in the UK and is responsible for more than a quarter of all cancer deaths.

University of Cambridge scientists studied brain scans of more than 800 people taken when they were 14, 19 and 24 and analysed any impact smoking had.

They found that smokers were more likely to have a smaller region in the frontal lobe called the left ventromedial prefrontal cortex.

This part of the brain is linked to rule breaking and the study suggests people with a naturally smaller lobe are likely more inclined to break rules and be a renegade.

However, data also show that the right-hand side of the same brain region is also affected by smoking. This section is involved in controlling willpower and triggering feelings of pleasure and the scans reveal it shrinks in smokers.

“There was a reduction in brain grey matter volume in the left ventromedial prefrontal cortex which likely causes impulsive behaviour and rule breaking that leads to the initiation of cigarette smoking,” study author Prof Barbara Sahakian, from the University of Cambridge, told The Telegraph.

“Cigarette smoking leads to reductions in brain grey matter volume in the right ventromedial prefrontal cortex, which is associated with sensation seeking and pleasurable experiences that reinforces and maintains future cigarette smoking. This eventually leads to addiction.”

Source: The Telegraph, 15 August 2023

See also: Nature Communications - Association between vmPFC gray matter volume and smoking initiation in adolescents ([link removed])
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** International
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** USA: How a simple blood test can help detect lung cancer earlier

Researchers from the University of Texas MD Anderson Cancer Center have developed a blood test they say can help predict a person’s risk of dying from lung cancer when combined with a lung cancer risk model.

“Lung cancer is the leading cause of cancer death worldwide,” said Dr. Edwin Ostrin, an assistant professor of general internal medicine at The University of Texas MD Anderson Cancer Center and co-corresponding author of this study.

“A major reason for this is that small lung cancers usually do not lead to symptoms and around two-thirds of lung cancers are thus diagnosed when they are large and have already started to spread,” Ostrin explained to Medical News Today.

“While we have made tremendous headway in treating both early and late-stage lung cancer, long-term survival is dramatically lower in more advanced lung cancer,” he added. “Any tools to provide early detection of lung cancer, and thus shift the stage at diagnosis to an earlier stage, would save lives.”

According to Ostrin, doctors have known since 2011 that for those at the highest risk for lung cancer — those with a significant smoking history — screening using an annual low-dose computerized tomography (CT) scan can reduce death from lung cancer by 20%.

“However, only those with the heaviest smoking history are eligible for CT-based screening,” he said.

For this reason, Ostrin and his colleagues have been working on a four-protein biomarker panel (4MP) for lung cancer early detection for most of the past decade.

Source: Medical News Today, 15 August 2023

See also: Journal of Clinical Oncology - Mortality Benefit of a Blood-Based Biomarker Panel for Lung Cancer on the Basis of the Prostate, Lung, Colorectal, and Ovarian Cohort ([link removed])
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ASH Daily News is a digest of published news on smoking-related topics. ASH is not responsible for the content of external websites. ASH does not necessarily endorse the material contained in this bulletin.

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