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Gordon Wishart, Professor of Cancer Surgery, Consultant Breast and Endocrine Surgeon and Medical Director of HealthScreen UK, urges employers to provide cancer screening programmes to minimise the impact of the devastating disease on staff and business.

When I tell people that we are living in an epidemic of cancer, they often find it a rather startling statement. But it is absolutely the case. Currently, around 325,000 people in the UK are diagnosed with cancer every year, and 160,000 people die of it. One in three people in the UK now get cancer of one type in their lifetime, and cancer charity Macmillan estimates this figure will rise to almost one in two by the year 2020. It certainly meets all the criteria to justify calling it an epidemic.

This presents a huge challenge for employers. Of those 325,000 people diagnosed each year, over 100,000 are of working age. Estimates suggest that, in total, over 750,000 people of working age are now living with a cancer diagnosis. For HR, occupational health and health and safety professionals, this is an issue which is not going to go away.


AND WHAT SHOULD BE DONE? The bottom line for employers is that cancer will cause significant downtime among their employees or the partners of their employees, and will therefore impact upon their business. If the cancer is only picked up at a late stage, it is likely to require more treatment, more time off work, more time recovering and will cause an unavoidable reduction in productivity. Late detection is also far less likely to result in a positive outcome for those diagnosed.

There are other reasons why employers should be taking responsibility for this. Around 10,000 cancers in the UK are thought to be directly related to work. Some risk factors are well-known, such as exposure to sunlight, radiation, asbestos or smoke. Some factors are relatively little-known. Night shift work is now understood to increase cancer risk, as is working as part of a flight


crew. There are even more subtle ways in which work puts us at risk, however.

Take breast cancer as an example – my own area of expertise. Like other types of cancer, the incidence continues to increase, with around 50,000 new cases in the UK per annum (2011). That means a lifetime risk of one in eight, which is predicted to rise to one in seven by 2024.


Why this increase? There are known lifestyle factors, which include obesity and alcohol intake, both of which seem to be on the rise. But changes in working patterns are also to blame. A third of women in the UK work shifts that include an element of night work, and we now know that over a prolonged period this increases breast cancer risk by 50% (in men, shift work carries a similar increased risk of prostate cancer).

Other factors known to increase risk of breast cancer include having no children or having them late in life (i.e. after 25) and not breast feeding. With pressure on women to have both a career and a family, many put off having children, or decide not to have them at all because of a desire or need to work – thus putting themselves at increased breast cancer risk.

Even those people working 9 to 5 in comfortable offices are not necessarily immune from increased risk at work. Stress is a known contributor, and studies in the US show that sitting for long periods of time increases risk of colon, endometrial, and lung cancer, prompting US commentators to claim that “sitting is the new smoking”.

There are positive signs, however. While rates of breast cancer have increased, the mortality rate has been steadily falling since the 1980s. Figures from 2011 show the number of deaths to be 11,762, with a fall of 45% for women aged 50-64 since 1989. The key reasons for this are higher awareness and improved methods of detection, which catch the cancer early. With other cancers, however – especially those for which there are no national screening programmes – the survival rate remains poor.

Successes with breast cancer show us the way forward; with the right methods of detection and equivalent levels of screening and awareness extended to other common cancers, similar survival rates can be achieved. The six most common cancers – breast, bowel, lung, skin, prostate and cervical cancer – account for about 88% of all cancer cases.

One means of achieving this is in the hands of employers, who can offer educational and screening programmes in the workplace – a service currently facilitated by organisations such as HealthScreen UK. We use screening methods that are often more advanced than those currently in use in the NHS, and some of these are not available on the NHS at all, or are only offered when you report to your GP with symptoms. By making screening available across the board to those most at risk within a workforce, we aim to catch potential cancers before they make themselves known – when they cost less to treat, and can be tackled with a far higher likelihood of success.

PROGRAMME IN ACTION Between May and August 2014, Lend Lease, an international property and infrastructure group, offered a skin cancer screening programme for its employees in EMEA in partnership with

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