A postcode lottery in cancer care means patients at some hospitals are up to six times more likely to be offered the chance to take part in potentially life-saving clinical trials than in the worst-performing areas.
Just one in ten patients at some hospital trusts have a conversation with their doctor about taking part in research of any kind, compared to six in ten at the best-performing trusts.
The national average is three in ten, according to data from a survey of more than 72,000 British cancer patients.
For some patients with incurable cancers, taking part in an experimental trial might be their only hope of extending their life.
The differences in the number of patients who discussed research with their doctor did not seem to be related to whether hospitals were large or small, or specialist or general – apart from the UK’s two specialist cancer hospitals, including The Christie (pictured), in Manchester
Studies have also shown taking part in research makes patients feel more satisfied with their overall care, possibly because they get more interaction with medical staff and more opportunities to talk about and understand their illness.
But experts said time pressures on busy medics might be deterring them from discussing the option with patients.
Analysis of data from the National Cancer Patient Experience Survey, carried out by the consumer forum of the National Cancer Research Institute, was presented at the NCRI conference this week.
The differences in the number of patients who discussed research with their doctor did not seem to be related to whether hospitals were large or small, or specialist or general – apart from the UK’s two specialist cancer hospitals The Christie, in Manchester, and the Royal Marsden, in London, which were both among the best.
Instead, researchers said it could be ‘pot luck’ whether patients were treated by doctors who took time to discuss research with them.
Co-author of the study, patient advocate Richard Stephens, said the size of the ‘geographical inequality’ was ‘worrying’.
He said: ‘There should never be such a big discrepancy between best and not-so-good – trusts are all part of the same national health service.’
He added: ‘Every trust in the country does research of some kind, although many people aren’t aware of this.
‘But we can’t explain why, nationally, we can’t sort out this consistent huge difference between the better performing trusts [for discussing research with patients] and the worst performing ones.
‘My own suspicion is that probably hospital staff who are busy and under pressure decide every now and then there are certain patients they are not going to have the conversation with.
‘It is a well-intentioned form of paternalism.’
Commenting on the study, Professor Johann de Bono, of the Institute of Cancer Research, said: ‘Most jobbing cancer specialists are so busy, their clinics are so large, it is very difficult for clinicians to have the time to explain trials to patients.
‘There are some really amazing therapeutic strategies being evaluated and I know for certain that many patients have had huge benefit from trials.
Just one in ten patients at some hospital trusts have a conversation with their doctor about taking part in research of any kind, compared to six in ten at the best-performing trusts. Pictured: The Royal Marsden, in London, the other specialist cancer hospital in the UK
‘But you also have to be aware these trials carry some risks, especially of side effects, they often involve an increase in commitment and they’re not for everyone.’
He added: ‘Although overall as a country we do very well in getting patients into trials, patients and their families should ask for that opportunity and if it’s not available where they are they should ask to be referred – especially if they have no other treatment options.
Emlyn Samuel, from Cancer Research UK, said: ‘Research is the key to improving outcomes for people affected by cancer so it’s crucial that all NHS Trusts are involved – offering patients all possible opportunities to participate, regardless of where they live.’
Britain is one of the best countries in the world at recruiting cancer patients into research, despite the regional variation.
The researchers did not identify which hospitals were the worst-peforming.