Breast cancer patients "being failed"

13/07/2007

A seven year study has revealed that the "two week wait rule" introduced in 1998 by the Department of Health is failing breast cancer patients and needs to be urgently reviewed.

 

The rule was brought in to counteract the high death rates from breast cancer in the UK - which were among the highest in Europe -  and stipulated that  by April 1999 all patients with suspected breast cancer should be seen by a specialist within two weeks of referral by a GP.

Many studies have questioned the validity of the two week wait rule, but this is the first to assess the long term impact. Author Dr Shelley Potter and colleagues gathered data on the number, route and outcome of 24,999 Primary Care referrals to the Frenchay Breast Care Centre in Bristol between 1999 and 2005. GPs had classified each patient as being either ‘urgent’ according to the two week wait criteria or ‘routine’. Between 1999 and 2005 the number of annual referrals to the centre increased by 9%.

Routine referrals decreased by 24% and two-week wait referrals increased by 42%. But the researchers found the that percentage of patients actually diagnosed with cancer in the two-week wait group decreased from 12.8% to 7.7% whilst the number of cancers detected in the ‘routine’ group increased from 2.5% to 5.3% over the same time period. In 2005 more than one in four patients ultimately diagnosed with cancer in 2005 was referred non-urgently.

Dr Potter said: “These "routine" patients are being disadvantaged by longer clinic waits and delays in diagnosis because waiting times for routine referrals have increased in the face of increasing service demands from the dramatically increased number of patients referred under the two week rule - 90% of whom have benign disease.”

Despite increasing numbers of referrals, waiting times for the 2 week wait group were always well maintained say the authors. However waiting times for routine referrals increased, these patients currently have to wait 30 days.

They concluded by saying: “The system is failing patients and a change is urgently needed.”