Treatment delays for cancer patients

CANCER patients face delays of up to four months for hospital treatment after their symptoms are recognised by family doctors, according to a study of diagnosis and referrals published today.

Doctors have been urged to review their diagnostic procedures in the light of the long waiting times for treatment of some of the most common types of cancer that emerge from the four-year study.

Men who developed the disease in the prostate gland had the longest delays between diagnosis and hospital treatment - 16 weeks on average. That compared with 13 weeks for people with stomach and oesophagus cancers, and 10 weeks for those with lung cancer.

Breast cancer sufferers had the quickest treatment, within four weeks. Most were referred by GPs for hospital investigation immediately on suspecting that the disease was present.

The study analysed the speed of diagnosis, referral and treatment of nearly 1,500 people with confirmed cancer diagnosis in Devon between 1986 and 1990. Robert Jones and Timothy Dudgeon, researchers at the University of Exeter's postgraduate medical school, analysed the records kept by 245 GPs over the four years. They found the delays were concentrated during the period between the initial GP consultation and the time of referral.

According to a survey published earlier this year by the Royal College of General Practitioners, patients wait longer to see a specialist in the UK than in any other European country. Only 39 per cent of British patients get their first hospital appointment within four weeks of a GP referral, compared with 92 per cent in France and 85 per cent in Spain.

The authors of today's study in the British Journal of General Practice suggest the long intervals may be occurring because GPs are commonly failing to spot symptoms of cancer, or wrongly attributing them to other illnesses. 'The reasons for delay among general practitioners and hospital staff as a whole are complex and require further investigation.'

People who suffer ill-health as a result of passive smoking at work may be able to sue their employers for damages, according to a legal opinion obtained by Action on Smoking and Health (ASH). Employers break their common-law duty of care for staff health at work when they deny them smoke-free air, it states. The dangers of passive smoking have now been sufficiently documented to warrant prosecution by environmental health officers, or the Health and Safety Executive, of those employers who allow it, Patrick Elias QC says.

With the backing of the Health Education Authority and the National Asthma Campaign, ASH is distributing copies of the legal opinion to environmental health officers and other enforcement agencies in the hope of prompting a test case.