According to a recent study women diagnosed with advanced Ovarian Cancer are less likely to survive in the UK than in other comparable countries. Rates of survival for more than one year after diagnosis were 69% in the UK compared with 75% in Australia and Canada, around 74% in Norway and 72% in Denmark. Cancer UK described the figures as ‘disturbing’.
Figures can be misleading and the obvious conclusion might be that treatment here is not so good. That is probably one factor but there is more to it. There have been suggestions in the past that patients report symptoms to their GPs at a later stage than elsewhere but the evidence in fact suggests that similar proportions of patients present at each stage in the countries studied. So we cannot blame the patients for ignoring their symptoms. Further there is no problem with availability of drugs and we cannot blame the NHS for failing to prescribe effective but expensive medication.
One factor is that patients may be in worse health, many suffering from obesity, diabetes or cardiac disease that makes treatment more difficult and may rule out surgery in some cases. However Professor John Butler of the Royal Marsden Hospital, a specialist Cancer treatment centre and one of the study’s authors identifies the lack of specialist surgery as a significant factor. The most important treatment for Ovarian Cancer is radical surgery which ideally needs to be performed by specialists who combine expertise in surgery, Cancer and oncology. There are few centres where such specialists are available and, particularly where an operation is needed urgently there may simply not be time to get the patients there.
Whilst much healthcare on the NHS is excellent, clinical mistakes play a role in delaying diagnosis. My colleagues and I regularly deal with cases where mistakes have been made because of failures by GPs to investigate symptoms and make referrals, mistakes in reading x-rays, scans and pathology samples or just basic administration going wrong. In one case for instance a scan was correctly interpreted but the results never made their way to the patient’s file.
The recent research into Ovarian Cancer unfortunately confirms a pattern which we see elsewhere: that despite many good things about the NHS we are consistently not doing as well as other comparable countries in dealing with Cancer of various types. It is important that we understand the reasons for this to make sure patients get the best possible care.
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