Trans people in England missing out on vital cancer screening, experts warn

September192024

Thousands of transgender patients in England are missing out on vital cancer screening because of the way their GP records are drawn up, experts have warned,Everyone registered as female with their GP is automatically invited to breast screening from the age of 50 to 70, and to regular cervical screenings from 25 to 64,But warnings from experts at the World Cancer Congress in Geneva this week, underscored by official NHS guidance, show that many trans patients are not invited to undergo the tests,In England, trans men who were registered female at birth and have changed the gender on their patient record to male are not offered breast or cervical screening, regardless of whether they have had chest reconstruction or a hysterectomy,Trans women who are still registered male with their GP are also not offered routine breast screening, even if they have been on longterm hormone therapy, which puts them at added risk of breast cancer.

Experts say the problem is the way GP electronic records in England are updated when patients change their gender.NHS England stipulates that when a patient changes their registered gender, they are given a new NHS number and must be registered as a new patient at their GP practice.All their previous medical history is transferred into their new medical record and their previous name, sex at birth, any other gender-specific terms and old NHS number are removed.Because the breast and cervical screening programmes use patients’ current gender to generate appointment invitations, many trans patients are missing out.Wider cancer statistics – such as screening uptake, the stage at diagnosis, adherence to treatment and outcomes – are all also unrecorded for trans cancer patients.

There are estimated to be between 200,000 and 500,000 trans people in the UK.Speaking from the summit in Geneva, Stewart O’Callaghan, the chief executive of the charity OutPatients, said: “Even if only 10% change the gender on their GP record, that means tens of thousands are unable to easily access a routine mammogram or smear test that could detect cancer early and save lives.”The NHS guidance says trans patients who are excluded from these national screening programmes can request a mammogram or smear from their GP, but family doctors are not routinely trained on how to discuss screening with trans patients or ensure they have the same access to tests, reminders and follow-ups.Dr Alison May Berner, an oncologist specialising in cancer care for trans people who was also at the World Cancer Congress, said: “We all have busy lives and rely on these vital systems to remind us to access screening.On top of that, these screenings can be dysphoric for trans people.

“Putting the burden on the individual to approach the GP compounds existing healthcare inequalities for trans patients.”Gemma Peters, the chief executive of Macmillan Cancer Support, said: “Research shows that transgender people are more likely to be exposed to a number of risk factors for cancer, while their access to timely and effective care is affected by a range of complex issues.From screening and diagnosis through to treatment and support, it is essential that trans people get the care they need and are entitled to.The reality is that health inequities endanger lives.”O’Callaghan said more could be done.

“The system needs to find a way to track trans status without removing a person’s right to privacy,They added: “A potential solution would be having both gender and sex registered at birth on the patient record, but the latter only being accessible at a system level or by clinicians with permission,But any solution to this issue must be co-created with trans patients directly,”

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UK consumer confidence tumbles as households fear ‘painful’ budget; UK debt hits 100% of GDP – as it happened

Good morning, and welcome to our rolling coverage of business, the financial markets and the world economy.Fears of a ‘painful budget’ next month have knocked morale among UK consumers – a bad sign for the economy.The latest poll of UK consumer confidence has fallen sharply this month, with optimism over people’s personal finances, their purchase intentions, and the state of the economy all sharply lower than in August.The index, published by data provider GfK, has dropped to -20 this month, down from -13 in August.That is the lowest reading since March, when the index was -21,Consumer confidence had been improving as the economy grew robustly in the first half of this year and inflation dropped

September202024

UK debt hits 100% of GDP, the highest level since 1960s

The scale of the challenge facing Rachel Reeves ahead of the autumn budget has been laid bare by a rise in Britain’s national debt to the highest levels since the 1960s and a collapse in consumer confidence.Figures from the Office for National Statistics (ONS) showed the government’s outstanding debt pile reached 100% of gross domestic product in August, the highest level since 1961, as monthly borrowing rose by more than expected.Labour has warned repeatedly that the economic inheritance from the Conservatives will require “painful” decisions ahead of the 30 October budget, including tax rises and cuts to welfare benefits and other spending.Figures released by data provider GfK on Friday revealed a sharp fall in consumer confidence in September to the lowest level since March, blaming households’ concern about Reeves’s cuts to winter fuel payments and the prospect of further spending restraint at the budget.“Consumers’ reaction to the government’s warnings shows that Reeves will need to be careful to not overdo the fiscal tightening next month,” said Elliott Jordan-Doak, a senior economist at the consultancy Pantheon Macroeconomics

September202024

Packaging tax will raise price of many everyday items, say UK firms

A new packaging tax to fund recycling will push up the price of many products including soft drinks, beer, kitchenware and small appliances such as kettles and toasters, companies have warned.Pev Manners, the managing director of the cordial maker Belvoir Farm, said the preliminary cost for glass in the extended producer responsibility (EPR) for packaging was “nuts”. The brand would have to pass on the levy as the fees would wipe out its annual profits, he said.The EPR, which comes into effect next year, shifts the cost of household recycling from councils back on to the companies using the packaging.In August, the Department for Environment, Food and Rural Affairs (Defra) published its “first estimate” of the rates to be charged for each tonne of material, giving companies a price range from the lowest to the highest

September202024

Mars brings Marathon name back in UK as nostalgia rises for retro sweets

Depending on your age and resistance to change, potentially it never went away, but 34 years after the shock Snickers rebrand the Marathon bar is making a comeback in the UK.The decision to drop the British name for the treat caused uproar back in 1990 and some diehard fans have been complaining about it ever since. So, with this nostalgic audience in mind, Mars has announced it is making a “special Marathon retro edition”.The confectionery company said the revival was to mark a milestone for its UK business.“We’re excited to bring back the Marathon bar branding for a limited period,” said the senior brand manager Steve Waters

September202024

Thames Water warns its cash may run out as soon as December

The UK’s biggest water supplier is scrambling to shore up its finances, admitting it faces a shortage of cash as soon as December.The warning from Thames Water comes as some of its biggest lenders are considering easing repayment terms as it fights for survival, with lenders concerned their loans risk being wiped out if the company is temporarily nationalised.Talks with creditors would only allow for enough funds to last until spring next year. Any agreement would therefore mark just a step on the road to a potential restructuring – staving off the immediate risk of insolvency.The company announced on Friday morning it was seeking fresh repayment terms, confirming it had only about £1

September202024

UK consumer confidence falls sharply amid fears of ‘painful’ budget

Consumer confidence in the UK has fallen sharply amid growing concerns over government plans for a “painful” budget, risking a hit to the economic recovery from the cost of living crisis.The latest barometer of sentiment from the data company GfK found consumer confidence fell to the lowest level since March, wiping out progress made this year to rebuild household morale.Neil Bellamy, the consumer insights director at GfK, said the “major correction” in the outlook for personal finances had come despite a return to stable inflation earlier this year, lower borrowing costs and resilient wage growth.“Following the withdrawal of the winter fuel payments, and clear warnings of further difficult decisions to come on tax, spending and welfare, consumers are nervously awaiting the budget decisions on 30 October,” he said.Keir Starmer said last month that the new government would need to take “painful” decisions in the autumn budget after finding what Labour calls a “£22bn black hole” in the public finances

September202024

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