Adapted from BMJ 21-28 Feb 2026 Scarlett McNally
The national cancer plan for England aims to reduce cancer onset and improve the five year survival rate to 75%. It lists 31 steps that should bring us closer to that goal. These include improving patient centredness, care pathways, preparation for treatment, and prevention.
Many people think that cancer should be treated as a chronic condition. Half of us will get cancer and 38% of new cancer diagnoses are in those over 75.
Shared decision making should be realistic and forward looking, discussing interventions and alternatives with patients in line with their values and wishes. Not everyone wants excessive treatment or to face the risk of major complications. End of life care may be their priority instead.
The cancer plan wants to support palliative care hubs and hospice outreach services. Clinicians need to be realistic with patients. Sometimes the quality of time matters to the patient a lot more than quantity.
Physical activity should be promoted to cancer patients. The 2025 Challenge trial showed that an exercise programme reduced the risk of death from bowel cancer by 37% and of recurrent or new cancer by 28% over eight years. In this study, both arms were given information, but the extra intervention was support to actually accomplish the exercise programme. Patients need simplicity, clarity and practical information.
30% of cancers are preventable and action on smoking, obesity and highly processed food needs to be taken. The cancer plan advocates for genomic testing. But with or without this, we can all reduce our chances of getting cancer by physical exercise and activity.
Exercise can reduce the risk of breast cancer by 25% and bowel cancer by 45%.
The plan wants to move towards pre-emptive, data driven cancer care, using genomics, artificial intelligence, digital diagnostics and personalised treatment pathways. Yet, it does not tackle current problems such as recruitment freezes, diagnostic bottlenecks, and a shortage of radiology and histopathology workforce. For instance the target turnaround of histopathology is 98% within ten days. Currently it is achieved 68% of the time.
My comment: My husband and I were picked at random to be included in a target of 5 million UK residents in the Future Health study. They asked about basic health characteristics, previous personal and family history, and will test some baseline blood tests and elicit our genomes. We won’t personally benefit from this, but it is hoped that amassing data about what genes are related to various health outcomes may help others in the future.
Diabetes Diet 