Catching up on cancer diagnosis

By Deborah Cohen
Editor, Catching up with Cancer

Late presentation can be a serious problem

Survival rates from cancer in the UK are poorer than in much of Europe.

One reason is that the disease is often diagnosed later here.

In many cancers it has been shown that the earlier the diagnosis the better the outcome.

Cancer patients in England, Scotland, Ireland and Wales do worse than people in France and Germany.

They are on a par with cancer patients in Poland and the Czech Republic in terms of surviving for as long as five years after diagnosis.

Sometimes the diagnosis comes late because GPs adopt a watch and wait approach.

In the Greater Manchester and Cheshire area around 500 patients unfortunately die from cancer each year because they present with their symptoms late Dr Ian Watson GP in Oldham

Dora has had breast cancer and when she developed a sore hip she visited her family doctor.

"I went quickly, but it was diagnosed that I'd torn the muscle from the pelvis," she said.

Dora was told to return to the surgery if it doesn't get better.

It didn't, and after 10 weeks she had an X-ray which found the cancer had moved to her bone.

Social class difference

Some of us are unwilling to seek medical help if we find a lump, or feel unwell.

I was throwing up by then and eventually someone came up to us and said sorry we can't see you today Lizzie Cancer patient, aged 16

There is a great difference between the social classes, and between men and women.

Men from lower classes are the least likely to get themselves checked out.

So once cancer is diagnosed it can be too late to do much about it.

Dr Ian Watson, a GP in Oldham working to bridge this gap, said: "We know that in the Greater Manchester and Cheshire area around 500 patients unfortunately die from cancer each year because they present with their symptoms late."

Dr Watson and colleagues are raising awareness of the need to get diagnosed.

"We go into bingo halls, pubs, bookies and leave beer mats with fliers about the symptoms of common cancers," he said.

Failing children

Cancer in children can be diagnosed late as well.

The UK doesn't do well in the early diagnosis of childhood cancer - particularly in the case of solid tumours Professor Sir Alan Craft Royal College of Paediatrics

Lizzie is now 16 and found out she had a rare form of brain tumour when she was nine, after suffering severe headaches and sickness.

Before she was diagnosed she and her mother spent a whole day in an A&E department at their local hospital without anyone realising how ill she was.

Lizzie recalls that by 5pm: "I was throwing up by then and eventually someone came up to us and said sorry we can't see you today."

Professor Sir Alan Craft of the Royal College of Paediatrics admits that: "The UK doesn't do well in the early diagnosis of childhood cancer, particularly in the case of solid tumours."

He says that Germany does much better than the UK because its doctors do routine examinations of children for such diseases.

The UK is planning to improve its surveillance of cancer in children.

Dr David Wrede, a consultant in gynaecological medicine in Somerset, says the problem is that to get diagnosis you have to visit the health centre or the A&E department of a hospital.

He argues that cancer cases would be picked up faster in the UK if we adopted the system found in parts of Europe.

"Here there are diagnostic specialists to whom the public can go directly," he said.

Dr Laurence Buckman, a GP in London, disagrees and maintains that the family doctor is the gatekeeper of cancer diagnosis.

"Our primary purpose is to detect disease amongst the so-called worried well," he said.

BBC Radio 4's Catching up with Cancer was broadcast on Monday, 4 February 2008 at 1100 GMT. The second episode will be broadcast on Tuesday, 5 February at 1100 GMT. You can listen to the both programmes afterwards at Radio 4's listen again page.