Nearly one in four cancer patients in England is diagnosed only when they arrive at hospital in an emergency, a national study suggests.
The National Cancer Intelligence Network (NCIN), which looked at data from diagnoses in 2007, found 23% of cases had been detected at that stage.
In the cases of acute leukaemia and brain cancer, half of cases were only discovered at a critical stage.
Cancer Research UK said more education was needed to recognise symptoms.
The NCIN report suggested those who were diagnosed only at the emergency stage were more likely to die within a year than those diagnosed earlier.
Harpal Kumar, the chief executive of Cancer Research UK, told the Daily Telegraph: "The figure for diagnoses via emergency presentations is way too high.
"This statistic helps explain why we have lower survival rates than we would hope to have, lower than the best countries in Europe.
We hope the government will seriously consider the best way to tackle this problem in their revised cancer strategy"
End QuoteSara HiomCancer Research UK
"We need screening programmes to be rolled out as early as possible and GPs given rapid access to the tests that will enable patients to be moved quickly through the system."
The survey suggested those on low incomes, elderly people and the under-25s were the most likely to be diagnosed at a late stage.
Only 3% of skin cancers went undetected until the emergency stage, compared with 58% of brain cancers.
Sara Hiom, director of health information at Cancer Research UK, said the late diagnosis levels were "alarmingly high".
She said: "We hope the government will seriously consider the best way to tackle this problem in their revised cancer strategy, which is due in the coming months."
A spokesman for the Department of Health said: "We are committed to improving cancer outcomes. Earlier diagnosis is crucial to match the best survival rates in Europe."
Last December, government cancer tsar Professor Mike Richards said the NHS in England needed to get better at diagnosing cancers at an earlier stage if it was to continue to improve survival rates.
He called for a greater focus on one-year survival rates, an indication that cancer was spotted at a treatable stage.
Have you had cancer diagnosed at a late stage? What was your experience? What can be done to improve the UK's detection rate for cancer? Use the form below to send us your experiences and comments.
11 November 2010Last updated at 19:05 ETBy Nick TriggleHealth reporter, BBC News
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Peter Carter, Royal College of Nursing: 'In some trusts we're seeing a raft of ill-advised cuts'
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The NHS faces a period of job cuts, clogged hospital wards and rising waiting times, nurse leaders have said.
The Royal College of Nursing said patients should be concerned about the future - despite the health service escaping the worst of the cuts.
The union said it had identified almost 27,000 posts it believes are under threat in the UK and warned that services could suffer in the future.
But NHS chiefs said any savings being made should not harm patient care.
The NHS in England was one of only two areas of spending not to be cut in the recent spending review.
Instead, it was given the equivalent of 0.1% annual rises for the next four years once inflation is taken into account.
Ageing population
But the RCN said because of things like the ageing population and the rising price of drugs the costs for the NHS were rising at a much higher rate than that.
In recent months, the union has been asking for evidence of job cuts from its members as well as asking freedom of information requests and analysing board papers.
In July it reported 10,000 posts could go, but said this figure has now increased to 26,841, the majority of which are front-line clinical posts.
But the union said the true figure could be much higher as it was clear some trusts were not being transparent about their plans.
Peter Carter, general secretary of the RCN, said: "Right now, staff are not only concerned about losing their jobs, they are concerned about keeping services open and how they will cope if they stay.
The situation at South West Essex Primary Care Trust could be the shape of things to come.
The trust is extending waiting times for routine operations by up to eight weeks as part of a �56m turnaround programme.
It is restricting access to a long list of hospital procedures, including tonsillectomies, cataract and hip operations. And it is stopping most IVF treatment.
The PCT has announced more than 200 job cuts with more to come.
Chief executive Andrew Pike says the measures are needed to bring local budgets back under control.
He says waiting times for operations will fall again as services become more efficient.
Unison is sceptical. The union says the plan is bound to affect the quality of care and that staff will not accept the changes without a fight.
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"The public should be really concerned about the potential impact to the NHS. I predict waiting will rise. It won't be too long before people start asking what is going on."
He said the cuts to local government budgets could lead to hospitals not being able to discharge patients because social services will be too stretched.
He also questioned whether it was right to be trying to make savings at a time when the NHS in England was undergoing one of its most ambitious reorganisations - primary care trusts are being scrapped and GPs given control over local budgets.
He said this could be a "recipe for de-stablilisation".
NHS chief executive Sir David Nicholson said staffing was a matter for local trusts.
But he added: "We have made it clear that efficiency savings must not impact adversely on patient care, and that every penny saved must be reinvested in support of front line services and improving quality."
The RCN also highlighted examples of waste that had been reported. These included issues such as TVs being programmed to come on when no-one is around to watch them and central heating malfunctions which mean they stay on all the time.
It even cited a rehabilitation clinic which had new wet rooms and height-adjustable baths installed at a cost of more than �60,000. Within months, services were moved and the facilities are no longer being used.
Shadow health secretary John Healey said: "This RCN report is an early warning of the strains that the NHS is under and looming problems for staff and patients."
BBC News website readers have been sending their reaction to this story. Here is a selection of their comments:
As a retired NHS nurse, my observations are that there has always been waste in the NHS. It is over-managed and over-specialised, with specialist nurses in every field but never actually of real value. As for the Royal College of Nursing they are all talk and no action. Cathy, Nantwich
Nursing professionals are probably in a better position to assess the impact of the funding freeze than any politician. This is another Con-Dem attempt to divert complaints and public anger away from central government, who implement policies at a local level where they have to adhere to it. Andrew, Birkenhead
Job cuts and NHS budgets are a real concern. I'm a third-year student nurse due to qualify at the end of this year and already having difficulty getting a job. One job I applied for, the post was withdrawn due to the funding for that job being cut. Adam, UK
With the cap on the amount trusts can earn through private patients being removed it means that as waiting times rise, those with money will be able to jump to the front of the queue as hospitals prioritise private patients over NHS patients. Once again, the poorer members of society are going to suffer the most. Alan McDermott, Worthing
If it is true that we are to lose vital front-line services, then this government should be put in the dock for defrauding the British public once again. As for Nick Clegg, he should hang his head in shame alongside Cameron for going back on their pledges. Geoff Shannon, Wirral
More than 20% of children tested showed signs of the bone disease rickets, Southampton University Hospitals NHS Trust said.
Consultant orthopaedic surgeon Prof Nicholas Clarke checked more than 200 of the city's children for bone problems caused by a lack of vitamin D.
He was astonished by the results, which, he said, were "very reminiscent of 17th Century England".
Prof Clarke works for Southampton General Hospital.
He said vitamin D supplements should be more widely adopted to halt the rise in cases.
The crippling bone disease can lead to deformities like bowed legs as well stunted growth and general ill-health.
A lack of vitamin D can be caused by poor diets and insufficient exposure to sunlight, which helps the body synthesise the vitamin.
Prof Clarke said: "A lot of the children we have seen have got low vitamin D and require treatment.
'Middle class and leafy'
"In my 22 years at Southampton General Hospital, this is a completely new occurrence in the south that has evolved over the last 12 to 24 months and we are seeing cases across the board, from areas of deprivation up to the middle classes.
"There is a real need to get national attention focused on the dangers this presents."
He added that the "modern lifestyle, which involves a lack of exposure to sunlight, but also covering up in sunshine" had contributed to the problem.
"The return of rickets in northern parts of the UK came as a surprise, despite the colder climate and lower levels of sunshine in the north, but what has developed in Southampton is quite astonishing," said Prof Clarke.
"We are facing the daunting prospect of an area like Southampton, where it is high income, middle class and leafy in its surroundings, seeing increasing numbers of children with rickets, which would have been inconceivable only a year or so ago."
10 November 2010Last updated at 19:39 ETBy Nick TriggleHealth reporter, BBC News
Hospitals must improve their care of elderly patients undergoing surgery, an independent review has concluded.
Pain management, nutrition and delays were all highlighted as problems by experts from the National Confidential Enquiry into Patient Outcome and Death.
Overall, just over a third of patients were judged to have had good treatment.
The review body analysed the care given to 820 people aged over 80 who died within 30 days of having surgery in England, Wales and Northern Ireland.
Many of these were patients admitted as emergencies following fractures or internal bleeding.
'Wake-up call'
Researchers used case notes and surveys of doctors to assess the quality of the treatment.
They concluded the care given to 38% of patients could be classed as good. More than half got care which had "room for improvement", while 6% received treatment that was less than satisfactory.
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Mike Weston says his mother Florence suffered "appalling care" when she fractured her hip
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One of the major problems was a lack of access to expert elderly care doctors - over two thirds of patients were not reviewed by such specialists.
A fifth of patients also experienced significant delays between admission and their operation, while pain management was lacking in many cases.
Report author Dr Kathy Wilkinson said: "I hope our report is a wake-up call."
There are about 1.25m people over the age of 85 in the UK - a figure which is set to double over the next five years.
Kieran Mullan from the Patients Association described the problem as a "national disgrace".
"We continue to be extremely concerned about the care of elderly patients in hospital. As a society, not just a health service, we should all look after our must vulnerable."
Michelle Mitchell, of the Age UK charity, said: "This report is a stark reminder that far too often older people in the UK receive second or even third rate care in hospital, condemning many of them to an early death."
Jo Webber, of the NHS Confederation, which represents hospitals, said the care of elderly surgery patients was often "complex".
But she added: "There is absolutely no excuse for poor care, regardless of the age of the person involved. "
The regulatory system at Stafford Hospital was "wholly ineffective", a public inquiry heard.
Lawyers for Cure the NHS, a campaigning group made up of relatives whose family members died at the hospital, said the health system "completely failed".
The hearing is the fifth into the hundreds of higher than expected deaths at the hospital between 2005 and 2008.
Earlier inquiries into a 2009 report which condemned conditions at the hospital were heard in private.
The new coalition government ordered that an inquiry be held in public.
A Healthcare Commission report, issued in 2009, listed a catalogue of failings including receptionists assessing patients arriving at A&E, a shortage of nurses and senior doctors and pressure on staff to meet targets.
Jeremy Hyam, counsel for Cure the NHS, said: "The stark and worrying concern is that the regulatory system supposedly in place was wholly ineffective to prevent a dramatic lowering of standards not just for a matter of months, but for at least four years."
The inquiry is the culmination of more than three years of campaigning by members of Cure to expose the failings at Stafford Hospital"
End QuoteJeremy HyamCounsel for Cure the NHS
He asked how the hospital had managed to get Foundation Trust status, at a time when the care being given to patients was so poor it was capable of amounting to inhuman and degrading treatment under the European Convention on Human Rights.
"The inquiry is the culmination of more than three years of campaigning by members of Cure to expose the failings at Stafford Hospital," Mr Hyam said.
It was not just patient care which was failing but also the failure of the Mid-Staffordshire NHS Trust, and its supervisory bodies to prioritise patient safety over targets, he added.
Concluding his opening speech he said the inquiry was a chance to look at the regulation system within the NHS.
"The shocking experience of Mid Staffordshire suggests that despite the array of supervisory, regulatory and commissioning bodies within the health system, their individual and combine work completely failed... to maintain basic standards of care, dignity and respect for human rights," Mr Hyam said.
9 November 2010Last updated at 19:01 ETBy Michelle RobertsHealth reporter, BBC News
Women would need far fewer smears if the NHS switched to a new way of screening for cervical cancer, a Cancer Research UK scientist has said.
Good uptake of the HPV vaccine that can prevent the cancer means we can now start to move away from conventional testing, said Professor Peter Sasieni.
Girls who have already had the jab would only need the new type of smear test twice in their lifetime, he said.
Unvaccinated women would halve their number of checks from 12 to six.
Professor Sasieni, a Cancer Research UK scientist at Queen Mary, University of London, has advised the NHS screening programme in the past about how to improve screening and his recommendation to change the age range of women invited for screening was adopted.
HPV testing could prevent an even greater proportion of cervical cancer with just half the number of screens over a lifetime in women who have not had the HPV vaccine"
End QuoteProfessor Peter SasieniCancer screening expert
The professor, who presented his predictions at the National Cancer Research Institute conference in Liverpool, is now urging the government to consider making HPV testing the main method of cervical screening.
Currently, women are invited for a conventional smear test that takes a sample of cells from the cervix to be examined under a microscope in the lab to check for early warning signs of cancer.
The HPV test, which is carried out in a similar way to conventional smears, instead checks for an infection called human papillomavirus, or HPV, which is a known cause of cancer of the cervix.
Time for a change
Professor Sasieni said: "The UK cervical screening programme has done a fantastic job in reducing cervical cancer, but it is based on an old screening test.
"HPV testing could prevent an even greater proportion of cervical cancer with just half the number of screens over a lifetime in women who have not had the HPV vaccine."
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And young women who have had the HPV jab would only need two screens giving the "all clear", one at the age of 30 and another at the age of 45, he said. Any with worrying results would be referred for more testing and treatment as necessary.
Currently, women aged 25-49 are invited for cervical screening every three years, dropping to every five years between the ages of 50 and 64.
This means the average woman will undergo around 12 conventional smears in a lifetime.
Professor Sasieni says it is not that the old method is bad, more that it is now outdated and involves testing women many more times than necessary.
Data suggests one in five women do not turn up to have smears when invited.
Professor Sasieni says if HPV testing were to be rolled out from next year, it could be used nationally by 2015.
"With continued high coverage of HPV vaccination and targeting of screening resources towards unvaccinated women, cervical cancer should become a truly rare disease.
"And if the government plan for this change now, they could save hundreds of millions of pounds in the long run," he said.
In the UK, girls aged 12 to 13 are offered the HPV vaccine that protects against two strains of HPV, types 16 and 18. Girls have three injections over six months, given by a nurse.
Uptake in English schools has reached about 80% and in Scotland 90%.
Dr Lesley Walker, Cancer Research UK's director of cancer information, said the very high uptake of the vaccine in the UK had been a real success story.
"This is exciting and poses interesting questions for the screening programme in terms of the best way to screen women in the future who have been vaccinated.
"But for now it remains vitally important that all women continue to take up the invitation to go for screening when they receive it."
More than 2,800 women a year in the UK are diagnosed with cervical cancer and almost 1,000 die from it every year.
Professor Julietta Patnick, Director of the NHS Cancer Screening Programmes, said they were looking at how best to incorporate HPV testing into their current screening programme.
"Any plans to use HPV testing as a primary screening method will require rigorous investigation and testing, as well as the development of robust quality assurance protocols and standards, before it could be implemented."
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Have you had cancer diagnosed at a late stage? What was your experience? What can be done to improve the UK's detection rate for cancer? Use the form below to send us your experiences and comments.