A question of geography

In addition to this new spirit of cooperation, the NHS?s `Cancer Plan? ? launched in 2000 has extended screening provision for women up to the age of 70 and introduced a maximum one-month wait from diagnosis to treatment. There is also now a maximum two week wait from GP referral to specialist outpatient appointment for those in whom a cancer diagnosis is suspected. The plan outlined plans for increased funding of cancer services over a 10-year period.

There’s still a long way to go however. Elizabeth Davies says: ‘An American oncologist would have major concerns about some of the things we do in this country.’

Drawbacks
However, while it may look rosy on the other side of the Atlantic, there are some drawbacks to such an active approach. A New York Times poll reveals breast cancer is the most feared disease among American women, even though strokes and heart disease kill far more. Some doctors fear this public awareness may lead to over-treatment, with women insisting on very aggressive therapies even when their cancers are small and slow growing.

Likewise, widespread testing for the BRCA1 and BRCA2 genes – thought to indicate a higher than average risk of breast cancer – may also be causing more problems than it solves. Although the testing is also available on a reduced basis in Britain (given to people already considered to be at a high risk of developing the disease), the indiscriminate testing in the States has been blamed for spurring people into making unnecessary choices. After all, being diagnosed with the bad gene is not necessarily an indication that you will go on to develop the disease. There is also the attendant risk that if you test positive for the gene, some insurance companies will cancel your policy.

Over the page: could we be better off?