Earlier this year, the body which develops clinical advice for England and Wales issued new guidance on ovarian cancer, which is the fourth most common cancer killer of women in the UK. However, the equivalent body in Scotland is not due to issue new guidance until next year at the earliest.
New guidelines from National Institute for Health and Clinical Excellence (Nice) are expected to improve the diagnosis of the disease in women south of the Border, potentially saving lives.
But sufferers and campaigners have expressed concern that a delay in changing guidelines from the Scottish Intercollegiate Guidelines Network (Sign) means women in Scotland – where there are more than 600 new cases of the disease every year – will end up receiving a poorer service than women in England.
Kim Hawker, 45, from Perthshire, who is being treated for ovarian cancer after being misdiagnosed by a series of doctors, told The Herald she feared Scotland would quickly fall behind.
“I worry that after the change to the Nice guidelines, the difference between Scotland and England will get worse,” she said. “There already seems to be such a great division between England and Scotland. Looking at the care I could have had in England, it would have been far superior. The GPs have got to know the symptoms.”
One of the misdiagnoses Ms Hawker received was Irritable Bowel Syndrome (IBS), an issue directly addressed in detail by the new Nice guidelines but only mentioned as a common misdiagnosis in the Scottish advice.
English advice suggests that women over 50 reporting persistent IBS-like symptoms should be tested for ovarian cancer.
Frances Reid of the charity Target Ovarian Cancer, who helped draw up the new Nice guidance, said the Scottish guidelines did not give a comprehensive list of the key symptoms or highlight the importance of their frequency and were now seriously out of date.
She said the Health Minister Nicola Sturgeon had issued a statement to Ayr MSP John Scott saying there was a process to be followed and it was not due for updating until winter 2012.
This delay means the Scottish advice will not incorporate Nice guidance which suggests women should be tested for ovarian cancer if they report any of a list of symptoms persistently and frequently, including bloating, feeling full, pelvic pain and increased need to go to the toilet. Ms Hawker suffered all of these symptoms.
Ms Reid said: “Scottish women potentially will continue to face significant challenges in getting a correct diagnosis promptly while English women will have a better chance of being investigated sooner rather than later. Scottish GPs need to be updated about symptoms.” Target Ovarian Cancer has now launched a GP education module with the most up-to-date research available on its wesbite, targetorvariancancer.org.uk.
Ms Reid added that unless Scottish GPs familiarised themselves with this new knowledge on ovarian cancer, English women would have a better chance of being seen by a GP who was up to date.
Ms Reid urged Sign to consider revising its advice to GPs in Scotland as a matter of urgency. “We feel that women in Scotland are not being given the best information about symptoms and what to look out for,” she said.
A Scottish Government spokesman confirmed there was no plan to expedite the review of the Sign guidance. “Sign intends to intends to review and potentially update [the guidance] during the 2011-12 financial year and all new evidence will be taken into account during that process.
“The prompt diagnosis of cancer and the subsequent delivery of appropriate treatment are key priorities of both the Scottish Government and NHS Scotland.”
A spokesman for Sign said: “We are reviewing the new evidence relating to diagnosis and treatment of ovarian cancer. We are constantly making ourselves aware of new evidence that could positively influence the development of our guidelines for Scotland and will be taking all the relevant new evidence into accout during our review process.
“Our review of the evidence will be completed in the current financial year.”