Implementation of the two week wait rule for breast cancer referrals criticised

In collaboration with the Press Association

The 'two week wait rule', introduced by the Government in April 1999 to ensure people with suspected breast cancer see a specialist within two weeks of referral by a GP, is not helping breast cancer patients, according to researchers at Bristol's Frenchay Hospital.

The researchers claimed that an "alarming" number of patients with suspected breast cancer are waiting too long for a diagnosis.

Their study, published in the British Medical Journal, analysed data from 24,999 referrals to the Frenchay Breast Care Centre between 1999 and 2005, where the number of annual referrals increased by nine per cent during the period. Routine (non-urgent) referrals decreased by 24 per cent during the period, but the number of two week wait referrals increased by 42 per cent. Despite fluctuations in the numbers of referrals, the total number of cancer diagnoses remained constant.

However, the researchers found that while the percentage of patients diagnosed with cancer in the two week wait group decreased from 12.8 per cent to 7.7 per cent, the number detected in the 'routine' group increased from 2.5 per cent to 5.3 per cent.

In total, 27 per cent of the patients ultimately diagnosed with cancer in 2005 had been referred as non-urgent cases, a finding which Dr Shelley Potter described as "alarming".

Dr Potter, clinical fellow at the centre, commented: "These patients are also potentially being disadvantaged by longer clinic waits and delays in diagnosis as 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 wait rule, over 90 per cent of whom have benign disease."

The researchers noted that while the two week wait for urgent patients is well maintained, patients who are classed as routine referrals currently have to wait for 30 days before seeing a specialist.

"The system is failing patients and a change is urgently needed," they concluded.

Commenting on the findings, Hisham Hamed, Cancer Research UK breast surgeon, said: "Targets like the two week wait for referral help women because anxiety is minimised and patients know where they stand.

"It is of course the aim for all patients to be seen in the shortest possible time but is important to say that research shows an extra week or two will not compromise the patient's outcome. "And we should remember that the majority of the women referred do not have breast cancer," he added.