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Breast cancer delays 'put lives at risk'
Breast screening
Breast cancer patients should be seen within two weeks
NHS hospitals are failing to treat women with breast cancer quickly enough and the delays may be putting lives at risk, a study suggests.

Research carried out at King's College Hospital in London has found some women with breast cancer have waited as long as three months to be seen by specialists.


A GP should not have to distinguish between urgent and non-urgent breast cancer cases

Delyth Morgan, Breakthrough Breast Cancer
This is despite the introduction in 1999 of a two-week waiting time limit for urgent cases of suspected breast cancer.

The study suggested the problems were being caused by GPs wrongly identifying some women as non-urgent cases who then waited longer than two weeks for treatment.

Analysis

Consultant surgeon Jonathan Roberts and colleagues at Kings College Hospital examined referrals by GPs between April 1999 and December 2000.

Of the 3,597 referrals, 665 were marked as urgent and 2,932 as non-urgent.

Sixty-two urgent patients were subsequently found to have breast cancer.

However, 49 non-urgent patients were also diagnosed with the disease.

But the study also showed that pressure on doctors to see the urgent cases within two weeks meant some women had waited for as long as three months for treatment.

Writing in the British Medical Journal, the doctors said: "It is evident that the two week wait initiative is not ensuring that most patients with symptomatic cancer are seen within two weeks of referral."

That conclusion is backed up by a study last year by the British Association of Surgical Oncology last year which suggested as many as one in five patients who are referred to hospital as non-urgent cases actually have breast cancer.

The surgeons criticised the policy of getting GPs to decide which patients should be seen urgently.

They said: "By grading patient referrals, we are creating a two-tier structure, with patients in the non-urgent group waiting longer periods for diagnosis and treatment.

"For patients with cancers in this group the delay can be critical."

Change policy

They called on the Department of Health to force all patients with suspected breast cancer to be seen within two weeks.

The surgeons said they had succeeded in introducing the two-week limit for all patients by simply reorganising the way their unit works.

A spokeswoman for the Department of Health said: "Clearly it is important that the right people are urgently referred. GPs have cancer referral guidelines to help them to decide who needs to be referred urgently."

She added: "Speeding up the way cancer patients are diagnosed and treated is central to the government's programme for modernising cancer services."

But Delyth Morgan, chief executive of the charity Breakthrough Breast Cancer, echoed the surgeons' call.

"Breakthrough has been concerned about the use of referral guidelines for some time.

"A GP should not have to distinguish between urgent and non-urgent breast cancer cases."

"If some units can see all women referred in two weeks, then why not all?"

Dr John Toy, Cancer Research UK's Medical Director said the study findings showed that "even best intentioned approaches to improving cancer patient outcomes will fail if they are too simplistic or flawed in design."

Liberal Democrat health spokesman Dr Evan Harris said he had been campaigning against the two week "gimmick" since it was announced.

"This is exactly the sort of problem we forecast where a significant number of cancers would be in the non urgent group," he said.

"There is no evidence basis for the two-week wait policy but it is well known that delaying treatment or delaying diagnosis for those not referred urgently can cost lives".

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The BBC's Sophie Hutchinson
"The government has welcomed today's report"
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15 Mar 02 | Health
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