Hundreds Left With Long Wait In Two-Tier Cancer List

Hundreds of cancer patients, excluded from government waiting times through no fault of their own, can wait twice or even three times as long to start vital treatment as those in the official queue, The Herald can reveal today.

The key difference between the two groups is the way they were referred to hospital by their GP. Only those urgently referred – because they appeared more likely to have cancer – qualify for the government’s target of starting treatment within two months.

However, The Herald’s investigation shows that every year well over 1000 people who were not urgently referred to hospital were diagnosed with breast and bowel cancer alone.

Figures, obtained under the Freedom of Information Act, reveal bowel cancer patients who were not urgently referred to hospital waited months longer to start treatment than those who had urgent referrals.

The difference between the delays experienced by both sets of breast cancer patients is much smaller – although the average wait is almost a fortnight longer in one region.

Clinicians are divided about the system with some doctors calling for the target to be scrapped. Patient charities described the findings as “highly concerning”.

Ian Beaumont, campaign director for Bowel Cancer UK, said: “It is concerning there is such disparity between waiting times and we are doing all we can to help improve the system. We have to move to a more pro-active system ruling out cancer first, not last.”

Some of the biggest discrepancies in waiting times were recorded in the west of Scotland.

In the first months of 2007 in Greater Glasgow the median wait for treatment among urgently referred bowel cancer patients was just 27 days. However, for non-urgent referrals the median wait was more than three months – 97 days.

In Lanarkshire last year the median wait for urgent referrals was 47 days and for non-urgent 107, while non-urgent Tayside patients faced an average delay of 115 days.

Dr Bob Masterton, lead clinician for the West of Scotland Cancer Network, said, unlike breast cancer, bowel cancer could be hard to spot.

He explained: “If you’ve got piles and you are referred to hospital and it turns out you have cancer, the referral into the hospital is for piles and that is not an urgent condition. The vast majority of people with piles do not have cancer. But colorectal cancer is one of the things that can be associated with piles.”

Dr Masterton said once cancer had been diagnosed all patients had the same access to treatment. The delays, he said, occur when the patient is waiting for their first meeting with a consultant. He stressed these delays were not long enough to change the prognosis for those with cancer.

However, he added: “It’s obviously a disadvantage, we don’t pretend otherwise. Because we’ve recognised that, we are introducing bowel cancer screening programmes.”

This scheme, which invites patients over the age of 50 to send a stool sample for testing, is being rolled out across Scotland. However, there are concerns about how hospital staff will cope with all those patients who will need further investigation after screening.

Professor Malcolm Dunlop, professor of coloproctology at Edinburgh University and the Western General Hospital, said: “The net result is good, but there are a lot of potential downsides to this. There are not enough colonoscopists, there are not enough pathologists.”

A Scottish Government spokeswoman said: “Early diagnosis can mean the difference between life and death. That’s why we’re committed to rolling out the UK’s most comprehensive bowel screening programme.

“When implementation is complete around 650,000 people will be issued with home test kits and individuals will be screened once every two years. Evidence shows this will save around 150 lives every year.”