Doctors fear young women are missing early cancer diagnosis

Medical experts warn delays in sending under-45s to hospital put lives at risk

Young women are being denied early diagnosis of bladder cancer because of outdated guidelines discouraging referrals if they are under 45, experts warn.

Now women who have had to battle the cancer are campaigning for a change in the guidelines and greater awareness of the issue.

They are being backed by leading surgeons and a charity citing poorer survival from the cancer for women. Jaimin Bhatt, a consultant urologist at Queen Elizabeth University Hospital in Glasgow, says he is treating younger female patients than previously, some of whom had to push their GPS to refer them to hospital specialists.

His colleague Param Mariappan, of Edinburgh’s Western General Hospital, says he is also seeing more women in their 30s presenting with bladder cancer.

Cancer statistics show that women are less likely to get bladder cancer than men, but more likely to die from it due to late diagnosis.

Ca n c e r Re s e a rc h UK says death rates are higher in Scotland than elsewhere in the UK. And although those rates are falling, they are dropping more slowly in women than in men.

Bhatt said: “The guidelines should be changed to include referrals of patients who have blood in their urine at any age.

“Some of my patients are in their 30s, have young children and want to live to see them grow up.

“Yet it is not unusual to see women below 45 with cancers, some of which have spread beyond the bladder wall and it is my impression that they are increasing in number. Most have been diagnosed after being mistakenly treated for recurrent infections.”

Even after the cancer is detected not all patients complete treatment within the ideal time for best recovery, said Mariappan.

NHS S c o t l a n d’s Tre a t m e n t Time Guarantee insists that every health board must ensure patients receive in- patient and day case treatment within 12 weeks but the clock stops after the initial investigation and removal of the suspicious cancer site.

Mariappan said: “The route to vital follow- up treatment such as surgery to remove part or all of the bladder, or radiotherapy, is slow for some patients. It is not measured as part of the efficacy or effectiveness of the cancer’s full treatment.

“It falls short of NHS Scotland’s Quality Performance Indicator Programme where one of the demands stipulates that 90% of patients with muscle invasive bladder cancer should have either all or partial bladder removal or radiotherapy within 12 weeks of the diagnosis. The last three- year report suggests less than 80% of patients were treated within this timescale.”

The char ity Fight Bladder Cancer says there has been an increase in younger women with the condition. Chief executive Dr Lydia Makaroff said: “Awareness of symptoms such as recurrent bladder infections and blood in the urine is vital for an early diagnosis.

“A three- month delay means a reduction of the 10- year survival rate of more than 14%.”

The Scottish Government said: “The guidelines support GPS’ judgment in identifying patients most likely to have cancer and require urgent assessment by a specialist.

“Treatment decisions will be made with the patient taking account of their preferences and balancing the harms and benefits involved based on the referral guidelines and clinical judgement.”