ABSTRACT
Prostate cancer is now the most common cancer in men in the United Kingdom. It has been described as ‘the most mysterious of all cancers’ because of its natural history, and the uncertainties that surround its detection and management. During the 1990s, waiting times for referral to treatment were longer than for other cancers. The average waiting time from general practitioner referral to first definitive treatment for 90 per cent of all new prostate cancers was 143 days for men referred as urgent, and 292 days for others. In contrast, average waits for women with suspected breast cancer were 62 days (urgent) and 90 days (non-urgent) (Spurgeon et al., 2000). As a result of the considerable investment in cancer services made by government in the late 1990s, and in line with national targets for cancer, some anomalies between tumour types regarding waiting times had been eliminated by 2004-2005. Specifically, the target that all patients referred urgently by their general practitioner should receive a hospital appointment within a period of two weeks (‘the two-week wait’) was largely being met. By the first quarter of 2004, 98.7 per cent of urgent referrals for all urological cancers (including prostate cancer) were being seen by a consultant urologist within two weeks (Department of Health, 2004b). A further target, to be achieved by 2005, was that all patients referred as urgent should wait no longer than 62 days between general practitioner referral and first definitive treatment (‘the 62-day wait’). If this were achieved, it would banish the variation in waiting times across different cancers, but this was known to be more difficult to achieve with respect to prostate cancer without fundamental changes to assessment processes.
