(2) what percentage of patients have been treated for breast cancer within six weeks of (a) diagnosis and (b) referral by general practitioner over the last 12 months.
In the last three years 99.3 per cent. of patients with breast cancer were seen by a specialist within two weeks of urgent referral by their general practitioner, in England.
Data on waiting times for cancer treatment is not recorded in the format requested. In England, the NHS Cancer Plan introduced cancer waiting times standards of a maximum one month wait from diagnosis with breast cancer to first treatment and a maximum two months from urgent general practitioner referral to first treatment for breast cancer to be achieved from December 2001 and December 2002 respectively. In the last twelve months 98.9 per cent. of patients received treatment for breast cancer within one month of diagnosis and 98.1 per cent. received treatment within two months of urgent referral by their general practitioner.
Data on national health service performance on all cancer waiting times targets is published quarterly on the Departments’ website at:
A copy has been placed in the Library.
In May 2004, the international agency for research on cancer, part of the World Health Organisation, concluded that organised and quality controlled cervical screening can achieve an 80 per cent. reduction in the mortality of cervical cancer. Women aged 25 to 49 should be screened no more than every three years, and women aged 50 to 64 no more than every five years. This is in line with national policy on cervical screening in England.
In July 2004, Professor Julian Peto and colleagues published a paper in The Lancet, ‘The cervical cancer epidemic that screening has prevented in the UK’. The paper concluded that cervical screening has prevented an epidemic that would have killed about one in 65 of all British women born since 1950 and culminated in about 6,000 deaths per year in this the United Kingdom. 80 per cent. or more of these deaths, up to 5,000 deaths per year, are likely to be prevented by screening, which means that about 100,000 women will have been saved from premature death by the cervical screening programme by 20301.
The advisory committee on cervical screening meets twice a year to advise the Government on the development of cervical screening and to monitor its effectiveness and efficiency.
In 2004-05 in England, 80.3 per cent. of eligible women had a test result in the last five years2. 3.6 million women were screened and laboratories reported four million tests.
1 Peto et al, Lancet 2004; 364: 249-56.
2 National Statistics and The Information Centre for health and social care statistical bulletin, cervical screening programme, England: 2004-05.
Human papilloma virus (HPV) testing is currently only available in the national health service as part of research trials.
The Government are funding two such trials.
First is the trial of management of borderline and other low grade abnormal smears which is funded by the Medical Research Council. This study was set up to determine the most appropriate way to deal with HPV positive results and associated psychological issues. The study is due to report in 2007.
Second is a randomised trial of HPV testing in primary cervical screening, which is funded by the Department’s health technology assessment programme (HTA). This trial is investigating the use of HPV testing as a primary screening tool. The study is due to report in mid-2008.
In addition, as part of the Government-funded pilot study of liquid based cytology, the Department also piloted the use of HPV testing as triage for women with mild or borderline test results. There is currently insufficient evidence to support the use of HPV testing as a primary screening tool. However, we do not underestimate the importance of HPV in the development of cervical cancer.
Following the receipt of the independent evaluation report of the HPV arm of the pilot, the advisory committee on cervical screening has now set up a dedicated working group to advise on how best to introduce HPV testing into the NHS Cervical Screening Programme.
The Prostate Cancer Risk Management Programme (PCRMP) is being reviewed based on the evidence of the evaluation of the programme, which has been carried out by the Cancer Research UK primary care education research group.
The evaluation was extensive. Two literature reviews have already appeared in academic journals:
Patient information, informed decision-making and the psycho-social impact of Prostate Specific Antigen (PSA) testing (Hewitson et al, British Journal of Urology International 2005;95(S3): 16-32)
Reduction in uptake of PSA tests following decision aids: systematic review of current aids and their evaluations (Evans et al, Patient Education and Counselling 2005;58:13-26)
The results of an on-line questionnaire survey with 400 general practitioners (GPs) examining current reported PSA testing practice in primary care as well as GP attitudes towards informed decision-making and PSA testing were published in the journal British Medical Council Family Practice (Brett et al, 2005;6:24).
The results of a randomised trial of men’s knowledge, attitudes and intention to have a PSA test will be published in the journal Patient Education and Counselling later this year (Watson et al).
The results of an evaluation of the patient information sheet for men in the PCRMP information pack PSA testing for prostate cancer are due to be submitted to a journal shortly.
The report of a study to develop an understanding of what occurs in GP consultations which result in a request for a PSA test, from the perspective of the GP and the patient, is being written up prior to submitting for publication.
The PCRMP primary care packs will be rewritten based on the results of this extensive evaluation, and a consideration of any new evidence. This work will be overseen by the PCRMP scientific reference group, with close links to the prostate cancer advisory group and the National Institute for Health and Clinical Excellence prostate cancer guideline development group. The timing of the rewrite will depend on the extent of the changes to be made to the packs based on the evidence. A full consultation of the revised packs will take place. Funding will be made available to the national health service for this programme.