NHS cancer patients 'failing to be correctly monitored'

Concerns expressed that opportunities to save lives may be missed

Cancer patients in the UK may not receive enough follow-up after a diagnosis, a new study by researchers in Chicago suggests.

The study, presented at the annual American Society of Clinical Oncology in Chicago, suggests five years of monitoring is insufficient for some cancers and too long for others. The research suggests some NHS patients may receive too few years of follow-up care.

“This study highlights the importance of monitoring some cancer patients for extended periods,” said Dr Robert Dood, of the MD Anderson Cancer Center at the University of Texas. “Failing to monitor patients at greatest risk means opportunities to save their lives may be missed.”

His researchers used the American SEER database, which covers about 28% of the US population, to analyse when patients were no longer more likely to die than the general population. Overall, 2.3 million patients with 68 different cancer types were studied.

From those estimates, they determined ideal follow-ups for a number of cancers and concluded that grouping patients by cancer stage and structure could play a significant role in determining follow-up time.

Based on the study, researchers found high-risk surveillance periods could last anywhere from one month to 21 years. Researchers found the exact danger period for ovarian cancer was nine years, seven years for lung cancer and seven years for colon cancer. The shortest risk was less than one year for breast and prostate cancer and the longest risk was 19 years for gastrointestinal cancer.

NHS patients only receive five years of follow-up for ovarian cancer and five years of follow-up for lung cancer, according to charities. Some colon cancer patients may also miss minimum time frames for follow-up.

A spokesperson for the National Institute for Health and Care Excellence said that follow-up cases needed to “balance a number of factors” including “individual choice”, adding: “Our range of guidance provides advice on how doctors can work with patients to find out what they would prefer so together they decide what is appropriate for their circumstances.”

Joyce Robins, the director of Patient Concern, said it was “terrifying that cancer patients are being abandoned like this”.

“This is such a life-changing disease and to think that after recovering you’re on your own is very scary,” she said. “People should be getting the full follow-up they deserve at the time when they are still at high-risk.”

Dr Richard Russell, a respiratory physician and medical advisor to the British Lung Foundation, said a lack of evidence-based follow-up was unacceptable. “There is an urgent need to clarify this data in a UK population,” he said.

Joan Idris, a nurse advisor for Target Ovarian Cancer, said: “We are moving to a world where cancer diagnosis and treatment is more personalised. Follow up should too be based on the individual and the cancer type. Not all cancers are the same.”

However, she emphasised patient choice. “Further investigation would be needed into the emotional implications of a longer follow up and the support available to women,” she said.

Contributor

Jessica Glenza in Chicago

The GuardianTramp

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