Women with kidney or bladder cancer experience greater delays in diagnosis than men

Up to 700 women in England diagnosed with kidney or bladder cancer every year are experiencing a delay in being referred to a specialist, new research has revealed.

The finding could help explain why, unlike with many other cancer types, survival rates for kidney and bladder cancer tend to be worse in women than men.

The study looked at patients diagnosed with kidney and bladder cancers in England between 2009 and 2010, using data from the National Audit of Cancer Diagnosis in Primary Care, which covers 1,170 GP surgeries (about 14 per cent of the total).

Researchers looked at two interrelated measures of the promptness of diagnosis: the number of consultations the patient had before they were referred to a specialist, and the time between the first GP visit with symptoms and specialist referral.

Overall there was no substantial difference between men and women in the average time between first seeing a GP and being referred to a specialist. Women had to wait six days for bladder cancer, versus four days for men, and 16 days for kidney cancer, compared to 10 for men.

But among the 25 per cent of people who experienced the longest delays, women waited two weeks longer than men to get a referral to a specialist.

And when researchers looked at the 10 per cent with the longest delays, the figure rose to more than two months longer for women with bladder cancer, and more than three weeks for women with kidney cancer.

The delays may be because GPs have a tendency to attribute women’s initial symptoms to more common causes like bacterial infections, according to the authors of the study, published in BMJ Open.

Two-thirds of all patients with bladder cancer and one in four of those with kidney cancer had haematuria – blood in their urine – a tell-tale symptom for further investigation.

But the presence or absence of this symptom could not account for the gender split when it came to referral times, the study found.

Even when they came to see their GP with haematuria, women with bladder cancer were more than three times as likely to have three or more GP visits before referral, compared with men presenting the same symptom.

Women with kidney cancer were almost twice as likely as men to visit their family doctor at least three times with blood in their urine.

Hazel Nunn, head of health information at Cancer Research UK, said: “Early diagnosis is crucially important to cancer survival, so it’s worrying to see that some people – particularly women – don’t seem to be being referred as quickly as they could be.

“If you notice blood in your urine, even if it’s just once or twice, do make sure you get it checked out by your doctor.

“It’s likely to be something much less serious than cancer, but it is definitely worth getting it investigated.”

Nearly 3,000 women are diagnosed with each cancer every year in England, meaning that an estimated 700 women will experience delayed diagnosis and treatment, the study suggests.

Reinforcing the need to view blood in the urine as suspicious might prompt GPs to refer women more quickly, but it won’t help in those cases where this symptom is absent, warn the authors, who call for new approaches to tackle this issue.

“This research highlights both opportunities and challenges ahead in improving cancer diagnosis and patient experience,” study author Dr Yoryos Lyratzopoulos said.

“A more rigorous implementation of clinical guidelines will improve the speed of diagnosis for women with bladder and renal cancer who present with blood in the urine.

“However, we need to develop new tests and decision tools to help doctors to promptly diagnose those men or women with either cancer who present without the ‘red flag’ symptom of blood in the urine.”

Copyright Press Association 2013