Charity awards new grants to tackle unfairness in healthcare for women

Ovarian Cancer Action turns “Tampon Tax” funds into innovative IMPROVE UK project

• Aims to tackle postcode lottery around ovarian cancer diagnosis and care
• Prostate cancer survival rate revealed to be double that of ovarian cancer

To coincide with International Women’s Day, women’s health charity Ovarian Cancer Action today launches IMPROVE UK – an innovative project that aims to significantly reduce the unfairness women currently face in healthcare and the disproportionately low survival rates of women with ovarian cancer.

New research[i] reveals the number of men who live for 5-years or longer after a prostate cancer diagnosis is now 88% – double that of women with ovarian cancer.

A huge disparity also exists when it comes to the survival rates of women with ovarian cancer who live in different parts of the country, whilst men with prostate cancer are not facing the same postcode lottery[ii]. Separate research from Ovarian Cancer Action shows, while some parts of the UK, such as London, have among the best survival rates in the world, many areas including Wessex and the East Midlands, have the worst survival rates in Europe with as many as 2 in 3 women dying just 5 years after diagnosis.

Ovarian Cancer Action’s IMPROVE UK project is the first of its kind and is designed to significantly improve survival rates by ensuring that no matter where a woman lives in the UK, or her ethnicity, she can get the ovarian cancer diagnosis, treatment and care she needs.

In this first phase of IMPROVE UK, Ovarian Cancer Action has awarded six grants for pilot projects. The funding comes from a £1 million investment the charity secured from the UK Government Tampon Tax Fund.

It will bring together six NHS Cancer Centres across the UK to improve knowledge, best-practice, and data sharing. The pilots target a wide range of issues in the current system, in a bid to improve the access to high quality care for more women. These include:

• Introducing pre-habilitation services* for women, to ensure more can access lifesaving surgery – reducing the gap in survival rates
• Improving the uptake of genetic testing, especially in BAME communities
• Reducing delays from diagnosis to starting treatment

Following the pilots, Ovarian Cancer Action will share the learnings with other cancer centres across the UK to help drive wider changes and improved health services for women.

Cary Wakefield, CEO of Ovarian Cancer Action, says: “Women have been living with the inequality gap in care and treatment for too long and now is the time for action and change. We welcome the determination of those involved in the pilots to find solutions.” 

With this year’s International Women’s Day theme of Break the Bias, striving for a world free from bias, stereotypes and discrimination, Ovarian Cancer Action is playing its own part in working towards this shared goal to forge women’s equality by tackling systemic and regional health inequalities for women with ovarian cancer.

The IMPROVE UK project is also designed in response to previous work funded by the charity[iii] which revealed the unacceptable disparities in survival rates for different women:

• 5-year survival rates range from 29% to 50% across different regions in England
• Women over the age of 70 are less likely to receive any treatment compared to younger women
• Less uptake of important genetic testing in patients from BAME groups.

The launch of IMPROVE UK is supported by the British Gynaecological Cancer Society (BGCS), the ovarian cancer patient support charity Ovacome and a dedicated Patient Advisory Group.

Visit the Ovarian Cancer Action website to find out more about IMPROVE UK including further detail on each pilot project https://ovarian.org.uk/our-research/improve-uk/.

[i] NHS Digital (Survival by cancer group), National Disease Registration Service (NDRS), ‘Cancer Survival in England, cancers diagnosed 2015 to 2019, followed up to 2020’, published 3^rd February 2022.

[ii] NHS Digital (Geographic patterns of cancer survival), National Disease Registration Service (NDRS), ‘Cancer Survival in England, cancers diagnosed 2015 to 2019, followed up to 2020’, published 3^rd February 2022.

[iii] Ovarian Cancer Audit Feasibility Pilot, 2020.

Further detail on each region’s project:

Improving women’s outcomes and treatment recovery for advanced ovarian cancer at Belfast City Hospital

The team at Belfast City Hospital want to help more elderly and frail patients, who may not be considered fit enough for treatment, to receive life extending surgery and chemotherapy. Treatment for cancer is tough on the body and currently some women may not have access to these treatments as their bodies are not prepared. This creates a massive disadvantage for this group of women, which this project wants to reduce.

The team will set up a dedicated central clinic to assess frailty in patients with advanced ovarian cancer in Northern Ireland to help improve patient fitness before they undergo surgery and chemotherapy. This means treatment is more accessible, improving the chance of survival for this group of women. 

Belfast City Hospital is the regional gynaecological cancer centre for Northern Ireland, serving a population of 1.8 million, so the potential to help women in this area is huge.

Providing holistic care to patients to reduce inequalities at Royal United Hospital Bath and University Hospital Bristol

This pilot will implement a programme of holistic support programmes to reduce inequalities due to age, frailty, poor physical and mental health across Bath and Bristol. Older patients will have access to support from physiotherapists, occupational therapists, dietitians, geriatricians, nurse specialists and psychologists, to improve quality of life during and following on from treatment. This will mean more women will have better access to treatments that would normally not be available to this group, helping to narrow the survival gap between their oldest patients and younger counterparts in the long term. 

These centres serve a population of 2 million and care for over 150 patients with ovarian cancer every year. The number of older people is increasing quickly in this area, so combining the expertise in these two centres will help to support this growing community. 

Improving surgery through the IMPRESS initiative at the University of Manchester and surrounding hospitals

This project is a collaboration between six gynae-cancer centres (Lancashire Teaching Hospital, City Hospital Birmingham, Sheffield Teaching Hospital, Imperial College in London, Musgrove Park Hospital Somerset) to develop decision aids to help patients and their clinicians to make a shared decision about the best treatment options. The process of making treatment decisions for patients is often varied across the country, with patient preference rarely incorporated into this process. The decision aids will help to support the patient to make individual decisions about their treatment and allow cancer teams to harmonise their approaches to treatment, helping to reduce the ‘postcode lottery’ of treatment in this region. By empowering women to make personalised and evidence based decisions will help to improve outcomes for all women with ovarian cancer. 

The centres included in this study were chosen to represent a range of gynae oncology practices in the UK and includes a mix of larger and smaller centres with high and low surgical rates. 

Improving molecular ovarian cancer testing (DEMO) at the University of Birmingham and the University of Cambridge 

The pilot wants to improve uptake of genetic testing in women with ovarian cancer, especially in BAME communities that have the lowest rates of testing. This is mainly due to a lack of informed decision-making resources for women whose first language is not English. Genetic testing helps to improve the treatment pathway for each woman, helping more women to survive ovarian cancer. The team will co-produce audio-visual and written information in multiple languages, as well as exploring why some groups of women are more likely to decline genetic testing. The project will also produce nationwide consensus guidelines on best practices for taking patient biopsies, to ensure genetic tumour testing can be carried out and patients can benefit from personalised medicine. 

The Pan-Birmingham Gynaecological Cancer Network includes one regional centre and five gynaecological cancer units, supporting a diverse population of 2.2 million. This project builds on the team’s previous experience with the genetic testing studies, looking at BRCA testing in women with a new diagnosis of ovarian cancer before it became mainstream practice.

A one stop approach to reducing inequalities in care at Gateshead Health NHS Foundation Trust

The team at Gateshead want to streamline the patients journey from initial presentation to diagnosis and treatment by providing a one stop clinic. Instead of attending various different appointments at potentially different locations, decision making will be sped up for all patients through one team at one place. This is especially important for women who may be frail and unwell, reducing the number of hospital visits while ensuring the most appropriate treatment can start as quickly as possible. This will ensure patients across the North East and Cumbria receive equal access to the highest standard of care and ultimately have an equal chance of surviving the disease. The project will also improve access to clinical trials in the region, which will further improve patient experience and survival in the long term. 

The Northern Gynaecological Oncology Centre is part of Gateshead NHS Foundation Trust, which provides specialist gynae cancer services for over 700 women in the northeast of England. 

Improving patient access to pre-habilitation for cytoreductive surgery in Wales

This pilot wants to roll out a standardised approach to pre-habilitation for patients undergoing cytoreductive surgery (the removal of all visible tumours in the abdomen) for ovarian cancer across 3 centres in Wales: Cardiff, Bangor and Swansea. *Pre-habilitation means getting patients fit and ready for surgery and leads to lower complication rates, better recovery and outcomes after major surgery. Even though this is recommended by national and international guidance, patients in Wales do not have access to these types of services. Providing this service will reduce the gap in survival rates in Wales compared to other parts of the UK, as well as giving older women better access to treatments. 

Cardiff, Bangor and Swansea cover a large and rural geographical area, seeing around 400 new cases of ovarian cancer per year. Joining these centres together will ensure that the women in this whole region can be given the chance of improved outcomes after treatment. 

For more information, email hannah.bourne@ovarian.org.uk or call 07453 293631

Ovarian Cancer Action is working towards a world where no woman dies of ovarian cancer. We’re investing in research projects across three vital areas: prevention, earlier diagnosis, and more effective treatments. Improvements in each of these areas will transform the lives of women today and for generations to come.