Cancer patients have been waiting up to 10 months for treatment, according to a national 'baseline audit' casting doubt on services' ability to improve at the pace demanded by the government and public.

A separate audit by cancer surgeons suggests that even for breast cancer - where efforts have been targeted - waiting times for surgery are getting longer.

The survey of 8,000 cases, diagnosed through the national breast screening programme by the British Association of Surgical Oncology, found that in 1997-98 only 43 per cent of women received diagnostic surgery within a two-week target set by the association, while 73 per cent of cases met its three-week target for therapeutic surgery.

This represented a worsening of the position since 1996-97 when 50 per cent of women were admitted within 14 days.

Provisional results for 1998-99 suggest that there has been 'no improvement' on the previous year, revealed Paul Sauven, a member of BASO's breast cancer specialty group.

The Department of Health this week announced a further improvement in waiting times for breast cancer outpatient appointments: 96 per cent of women are now seen within two weeks of an urgent referral.

But the value of the outpatient target - which will be extended to cover all cancer patients from April - is being increasingly questioned.

Mr Sauven said the government had given too much responsibility to GPs, who must decide what constitutes 'urgent', despite seeing on average only one new breast cancer patient a year.

'We did talk to the health secretary about this, but were told it wasn't negotiable.'

Professor of clinical oncology David Kerr, one of the the health services management centre team who conducted the 'baseline audit' on behalf of the DoH, said targets for the wait for treatment would be 'more relevant' than initial referral times. 'It is something we have talked to ministers about and they are sympathetic.'

But he said the outpatient target for breast cancer could be 'defended' by the need to shorten a worrying time for women.

Professor Kerr said he was 'surprised' by the huge waiting times revealed by the audit. Men with prostate cancer fared worst, with 90 per cent waiting an average of 292 days for treatment. Urgent prostate referrals waited 44 days for an outpatient appointment.

Urgent cervical cancer patients waited 123 days for treatment.

But Professor Kerr insisted that the raft of government initiatives since 1997 had made a great difference to services. 'Things have improved, ' he said.

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