More than 20 per cent of health authorities are still not following national guidelines for the drug treatment of breast and ovarian cancer, according to a survey.

The report, Is NICE Removing Postcode Prescribing? , produced by CancerBacup, a UK cancer information charity, shows that cancer treatment remains something of a lottery for patients dependent on where they live.

Several HAs in England and Wales, said the report, can still not confirm that patients are being offered the treatments as recommended by the National Institute for Clinical Excellence.

Judith Brodie, head of the charity's cancer support service, said the survey demonstrates that the majority of HAs understand the implications and force of NICE guidance and are committed to implementing it in practice.

However, one fifth of HAs do not.

In May, NICE said paclitaxel/ platinum combination therapy should be recommended in treating recurrent or resistant ovarian cancer if the patient had not previously received it. And in June it said both docetaxel and paclitaxel should be available for treating advanced breast cancer where initial chemotherapy had failed or was inappropriate.

Dr Ian Gibson MP, chair of the all-party parliamentary group on cancer, said: 'Obviously there is still some way to go to ensure that all women are being offered the treatments they deserve.'

In previous CancerBacup postcode surveys, the problem for HAs was found to be funding. The drugs recommended are quite expensive. But the charity's spokeswoman said the reason for delay now was that HAs were still carrying out assessments of local need.

'As the guidance came out in May and June of this year I think that is quite a long time to be still doing local assessments, ' she said.

The problem, however, may also lie with doctors. Dr Gibson said:

'It is all well and good to make funds available for treatments recommended by NICE, but if doctors do not know they can prescribe these medicines, women will continue to miss out on the treatments they need.'

CancerBacup has called on the government to make sure that all HAs have systems in place to guarantee full compliance with NICE guidance.