Experts warn variation in cancer diagnosis is “unacceptable”

Posted: 4th Nov 15 11:53 AM

Cancer Research UK has found an “unacceptable variation” between different areas of England after reviewing cancer cases from 2012 and 2013.

Opportunities to diagnose cancer patients earlier throughout England and increase their chances of survival are being missed, the charity warns.

They have said that, if all areas around England were as good as the best, as many as 20,000 cases of cancer could have been found sooner.

The North West was found to be one of the worst areas for a late diagnosis. Merseyside was the worst, with close to half of cancers being found at a late stage, compared to other areas, such as the South West, Bath, Gloucestershire and Swindon, where only 40% were diagnosed late.

If the gaps between areas are closed, up to another 1,000 patients in Merseyside could have been diagnosed earlier.

Cancer Research UK has said it is unclear why the variation has occurred. One reason was likely to be the types of cancer being diagnosed, as some are easier to spot than others. However, the charity has also said that there were likely to be other reasons that could be easier to tackle.

Other factors at play when determining why a cancer has not been diagnosed earlier could include the patient not going to their doctor as early as they could when symptoms arise, and GPs sometimes failing to suspect cancer or not referring patients for diagnostic tests properly.

Do earlier diagnoses matter?

Earlier diagnoses can make a significant difference to survival.

For the eight most common cancers, being diagnosed at Stage 1 or 2 means an individual has an 80% chance of surviving at least 10 years, compared to only 25% if the cancer is found at Stage 3 or 4.

How does an early diagnosis help those diagnosed with an asbestos-related cancer?

Sara Hiom, Director of Early Diagnosis at Cancer Research UK, said: “Wherever you live, an early diagnosis of cancer will give you more treatment options and a better chance of survival.”

Asbestos-related cancers, such as mesothelioma or an asbestos-related lung cancer can be tricky to diagnose early because of their long latency period of up to 50 years.

This extended latency period means that the disease may not be detected until symptoms arise. Often, by that time, the cancer could have spread to other parts of the body.

The 10 to 50 year latency period also means that a lot of patients are older and already suffering from a number of other illnesses that have symptoms that can ‘mask’ or ‘hide’ the presence of cancer.

Individuals whose mesothelioma is discovered in Stage 1 or 2 have a greater chance of surviving the disease for an extended period of time due to the fact that more treatment options will be available to them. Individuals diagnosed with Stage 3 or 4 mesothelioma will have fewer treatment options, and therefore a less favourable chance of survival.

The stage at which mesothelioma is discovered also affects whether or not the tumour can be operated on. Mesothelioma is a type of lung cancer and surgery is widely accepted as the most effective way of treating the terminal disease. Due to the previously mentioned latency period, surgery to remove the mesothelioma tumour is often not an option. However, if the disease is discovered in an early stage, a surgical procedure to remove the tumour may be a possibility, especially if the patient is otherwise healthy.

Early diagnosis campaign

Cancer Research UK will be launching an early diagnosis campaign from next week to encourage people to keep an eye on their bodies.

One of the key themes of NHS England’s cancer strategy was early diagnosis. The strategy, launched in the summer, has pledged to create a target for diagnosis – a four week time span from urgent referral from a GP to a cancer diagnosis – with the aim of saving lives.

A key component of this was to increase the ability of GPs to be able to order cancer tests directly themselves instead of having to go through a hospital consultant.

Maureen Baker, from the Royal College of GPs, said that this would make a difference, but also that GPs were still doing a good job.

She went on to say: “Where our patients live should not be a factor in their health outcomes.”

NHS England’s National Clinical Director for Cancer, Sean Duffy, has stated that the health service was working together to “deliver” on what was promised in their strategy.

Further reading

What is mesothelioma?

What is asbestos?