One in nine women will develop breast cancer

The target - set in April 1999 - aims for all women referred urgently by their GP with suspected breast cancer to see a hospital consultant within a fortnight.

But the researchers found that nearly two years later, while the proportion of women meeting the target had risen, waiting times for subsequent treatment had gone up and overall waiting times had not changed.

The problem with arbitrary targets is that they just seem to push patients from one queue to another Dr David Robinson

They found that radiotherapy patients in particular often face unacceptable waits for treatment.

They also found that women who went to their doctor with symptoms of breast cancer generally wait longer for an appointment than those diagnosed through screening - even though their cases may be more urgent.

Major audit

The researchers, from the Thames Cancer Registry, King's College London, examined audit data on waiting times from 19 hospitals in south east England.

They analysed the records of 5,750 women referred by their GP between July 1997 and December 2000 and treated for breast cancer in subsequent months, comparing those referred before and after the April 1999 watershed.

Following the introduction of the target, the proportion of women who saw a consultant within two weeks of referral rose from 66% to 75%.

And the average waiting time fell from 11 to 10 days.

But the proportion of women who received treatment within five weeks of their hospital appointment fell from 84% to 80% - and average waiting time increased from 16 to 20 days.

The chances of receiving treatment within five weeks varied depending on the form of treatment women were to receive first.

For those starting off on the drug tamoxifen the figure was 95%, for those requiring chemotherapy it was 81%, for surgery 77% and for radiotherapy it was just 53%.

Researcher Dr David Robinson said: "Our study suggests that the government's two-week target has changed little for women undergoing breast cancer treatment.

"The problem with arbitrary targets is that rather than bringing about a genuine and lasting improvement in cancer services, they just seem to push patients from one queue to another."

GP referral slower

A total of 86% of women whose cancers were detected by the screening programme saw a consultant within two weeks.

But for women who went to their doctors with symptoms of cancer the figure was just 68%.

Doctors believe that some symptomatic women may be referred non-urgently by their GPs, and that waiting times for non-urgent referrals may be increasing as consultants concentrate on meeting their targets for urgent referrals.

Dr Robinson said: "The effects we have observed reflect the risks inherent in a policy of targeting one element of the patient pathway in isolation."

Professor Robert Souhami, Cancer Research UK's Director of Clinical Research, said: "While we'd agree women should have a hospital appointment within a fortnight of referral, it's an achievement that's undermined if they then have to wait more than five weeks for treatment, as almost half of women needing radiotherapy are having to do now."

A Department of Health spokesman said: "Cancer patients need to be diagnosed and treated as quickly as possible.

"The two week wait target, which ensures people with cancer symptoms are seen by a specialist quickly, is part of the government's wider programme for modernising cancer services and one step in the work under way to speed up the whole patient journey."

Clara MacKay, director of policy and research at Breast Cancer Care said: "The increase in waiting times for treatment for women with breast cancer is a cause for concern.

"It is very reasonable for people with urgent breast health concerns to expect to see a consultant within two weeks.

"It is equally important for people with breast cancer to receive prompt treatment, once diagnosed."

The research is published in the British Journal of Cancer.