CANCER patients in the region have the lowest survival rates in the country, according to a major new report which highlights inequalities in care.

The National Audit Office (NAO) said measures introduced by the Department of Health in the past decade had led to more patients surviving the disease.

But it also found huge differences between rich and poor areas, and a postcode lottery of treatments available depending on where patients live.

The percentage of patients who survive cancer consistently favours London and the South of England, according to the NAO.

Edward Leigh, chairman of the Public Accounts Committee, said such health inequalities had "no place in a civilised society".

The NAO report - Tackling Cancer in England: Saving More Lives - said that the number of cases of cancer had increased by 31 per cent between 1971 and 2000, when the NHS Cancer Plan was published.

It put part of this increase down to more women starting to smoke in the late 1960s and a larger number of people ignoring warnings about avoiding the sun.

But while cases of cancer have increased, death rates have fallen by 12 per cent in 30 years.

Screening programmes for breast and prostate cancer and improved treatment have all contributed towards people surviving longer.

"Reductions in mortality have been observed in recent years in almost all parts of the country," said the report.

"However, the degree of improvement has not been uniform."

The NAO highlighted disturbing examples of so-called "postcode prescribing" across England.

The breast cancer treatment Herceptin saw its use increase dramatically after its approval by the National Institute of Clinical Excellence (Nice).

But despite the Nice recommendation, 18 months later there were huge variations between different parts of the country.

In south-west London, more than 90 per cent of women who were eligible to receive Herceptin got the drug.

But in Teesside, South Durham and North Yorkshire, only 20 per cent of women received the drug.

In the former Northern region, which includes North Durham, Tyneside and Wearside, 25 per cent got the drug.

The outlook for patients with prostate cancer in the North-East was also poor compared with their counterparts further south. Statistics showed that of prostate cancer patients in the Northern and Yorkshire area diagnosed between 1993 and 1995, only 52 per cent had survived, compared with 63 per cent in London. Lung cancer survival was also higher in London.

Other inequalities include the disparity in diagnostic scanners. By the end of this year, the Northern and Yorkshire area would have just over five scanners per million of the population compared with 9.3 per million in London.

"Cancer Tsar" Professor Mike Richards is carrying out a review of every region of the NHS to ensure treatments which had been approved nationally were getting through to patients.

The NAO discussed shortages of radiographers, pathologists and endoscopists, who examine the bowel, which also added to delays in patients getting treatment and decreasing their chances of survival.

The report also said some people did not go straight to their doctor when they thought they might have cancer, and some might have to wait some time before being referred to a specialist.

The NAO recommended that GPs should have better guidance on referring patients to give them the best chance of early treatment.

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