The All-Party Parliamentary Group on Breast Cancer said a survey of UK health authorities had found "worrying shortcomings" in breast cancer services.

The survey looked at whether hospitals were implementing the 1996 NHS Executive's guidelines on improving breast cancer care.

It found that only 13% of NHS trusts had implemented one of the main guidelines on offering women a triple assessment test on a single visit.

This consists of a clinical examination, a mammogram or ultrasound and a "fine needle" cytology, which involves cells being extracted from the breast and tested for cancer.

The guidelines say there is "fairly strong evidence" that triple assessments increase the accuracy and reduce the cost of diagnosis.

The survey also found that less than half of all trusts had a written policy on how staff should tell women they had cancer.

This is also a key part of the guidelines.

And it criticised the lack of mechanisms for monitoring whether the guidelines were being implemented.

Cause for concern

"The survey results give serious cause for concern," said Judith Church, secretary of the All-Party Parliamentary Group.

Breast cancer will affect one woman in 11 in the UK

"We have an excellent set of guidelines, produced after wide consultation and respected by everyone in the world of breast cancer, but we have no means for ensuring that they are implemented."

The group is calling on Health Secretary Frank Dobson to do more research into implementation of the guidelines, carry out an urgent audit into the availability of triple assessment and assure women who need tests that they will get a triple assessment.

The survey, which is funded by the Breakthrough Breast Cancer charity, is released at the end of breast cancer awareness month. According to the Cancer Research Campaign, one in 11 women in the UK will develop breast cancer during her lifetime.

'Rather alarming'

The NHS Confederation, which represents 90% of health authorities and trusts, said the results of the survey were "disappointing and rather alarming".

It agrees that triple assessment is the best method for detecting breast cancer.

A spokesman said lack of resources may be one reason hospitals were failing to implement the tests.

He said recent cancer guidelines set out a framework for quality care, but did not provide any extra funding to improve services.

"This may come on stream soon, though," he stated.

Doorstep services

He added that many people wanted cancer services on their doorstep, when they could get better services if they were concentrated in bigger hospitals.

"People do not want to travel a great distance, but it is often not possible to offer a comprehensive service on all sites," he said.

A report on cancer services by the government's former chief medical officer, Sir Kenneth Calman, called on hospitals to concentrate services at larger hospitals.

However, there has often been public distrust of moves to take services away from local hospitals.

The NHS Confederation says another problem is the way cancer specialists are overseen.

It believes proposed changes mean that it will be easier to make sure they conform to best practice guidelines.

He said: "There are no instant solutions, but the new quality framework on cancer gives more power to local mangement and national bodies to monitor consultants' work.