The number of people who develop mesothelioma in the UK has increased almost five-fold since the late 1970s, according to Cancer Research UK. Latest available figures show that in 2011 around 2,600 cases of mesothelioma were diagnosed – equivalent to 7 every day – despite the fatal disease accounting for less than one per cent of all cancers diagnosed in the UK.

Issues of an original lack of asbestos awareness to the health risks and recognising the symptoms of asbestosis disease – mesothelioma cancer, in particular – have sometimes proven to be difficult. Not least, because of the close similarities with other respiratory diseases and lung conditions. The problem is also compounded by a long incubation period of between 15 to 50 years from initial exposure to the eventual appearance of asbestosis symptoms. In many cases, a confirmed diagnosis is only made when the cancer has spread to an advanced stage.

Regional variations

A new report, published by the Health and Social Care Information Centre, suggests that “more needs to be done” to ensure that those suffering from asbestos-related cancer are seen by specialist clinicians. According to a study of 8,700 patients diagnosed with mesothelioma between 2008 and 2012, “wide variations” were discovered between different regions in the approach to treatment and care.

The report, based upon examining the data of a concentrated number of patients across England and Wales, reveals that around one in five patients were referred to cancer services after attending hospital as an emergency case, when it was highly likely that the cancer was already at a more advanced stage.

Concern has been expressed over the figures, which show that wide variations occur across different regions. While an emergency referral might only account for one in ten cases in some areas and four in ten in others, it was also found that the proportion of patients physically able to receive chemotherapy varied from one in five to three in five, depending on where a patient lives.

Diagnosis and referral

The findings coincide with the release by Cancer Research UK of their Incisive Health Report based upon data collected by Public Health England’s National Cancer Intelligence Network. In this report, it was found that “the current variation in stage of diagnosis, together with the variation in the number of patients who report a high number of repeat visits to their GP before receiving an onward referral suggests that some GPs are more successful than others in diagnosing cancer early.”

According to data results, 46 per cent of all cancers diagnosed in 2012 had already reached stage three or four, and potentially along with mesothelioma, the least detected were lung cancers, non-Hodgkin lymphoma and ovarian cancers. The report suggests that both the patient and doctor may be responsible for the findings. In the first instance, there may be a difficulty for a patient to identify and then communicate the effects of initial symptoms to their GP.

Mistaking symptoms

A key problem with mesothelioma, for example, has often been patients mistaking early symptoms, such as repeat coughing, tight chests and running out of breath, as a result of “old age”, being “unfit” a history of smoking or thinking they have come down with a severe bout of flu.

At the same time, patients may simply not make an immediate connection with occupational exposure to asbestos, and therefore, not convey the vital information to their GP. It can also be the case that some GPs may not necessarily have immediate access to and use of both primary care and specialist diagnostic equipment for the detection of cancers, such as mesothelioma.

A devastating legacy of Britain’s past industrial asbestos use, more than four in ten of mesothelioma cases still occur in people aged 75 and over. However, it has also been increasingly found that around one in twelve cases now occur in those aged under 60. The age group shift is attributed to indirect “environmental” exposure in workplaces, such as schools, nurseries and hospitals built or renovated with asbestos-containing materials up to the late 1970s and early 1980s.