A top doctor has called for equality in treatment after figures reveal breast cancer rates are rising in some parts of north Wales despite falls elsewhere.

The Director of Public Health for North Wales Health Authority, Dr Sandra Payne, said the service had a poor record on standards across its area.

Early detection via screening and continual education for women is vital if the target to cut deaths is to be achieved, she said in a report to the authority.

Rapid access to specialist teams and the development of new treatment regimes involving both chemotherapy and radiotherapy were essential, she added.

Deaths

Targets to cut breast cancer rates by 30% are not likely to be met in the authority's area where figures show a rise.

All other health authority areas in Wales are seeing a drop in the number of deaths.

Dr Payne said that there is a need for a discussion on the reorganisation of the service to ensure that women have access to similar services.

"We have a poor record in terms of the ability to meet standards across all north Wales," she said in her report.

"There is a need for discussions to be progressed on the reorganisation of services to ensure that all women have access to similar services.

Target not attained

"This is a challenge to all health care providers in north Wales and requires commitment and negotiation rather than financial investment alone."

She says that potential changes to the screening policy of Breast Test Wales will also influence future service requirements.

Cancer rate targets for health authorities include reducing deaths from breast cancer in older women by at least 30% by the year 2002.

"The trend for north Wales is level, with little indication that the target will be attained without intervention," the report said.

Mortality

Rates were significantly below target in Anglesey, Conwy, Denbighshire, Flintshire and Wrexham.

"Rates appear to be increasing, unlike all other health authority areas, which are now seeing a decline in mortality rates," she said.

Denbighshire had the highest mortality rate between 1990 and 1995.

Registrations for breast cancer have remained above the Welsh average for a number of years, with over 500 registrations a year.