The government's efforts to tackle cancer rates in England are being hampered by delays, staff shortages and a "postcode lottery" of care.

According to a report published on Friday, incidences of cancer increased by 31 per cent between 1971 and 2000.

The causes are thought to be an increase in women smoking in the 1960s, and a greater number of people ignoring advice about avoiding the sun.

In contrast, death rates have actually fallen by 12 per cent, thought to be due to improved treatment and new screening programmes for breast and prostate cancers.

However, rates were found to vary across the country - cancer patients in London and the south fared better than those in the north, with higher rates in areas of deprivation.

Luck of the draw

In addition the study, by the National Audit Office, found that despite NICE guidelines, there was evidence of "postcode prescribing".

While more than 90 per cent of women in south west London were eligible to receive the breast cancer treatment Herceptin, the same was true of just 40 per cent of women in west London, 20 per cent in north east London, and five per cent in Derby and Burton.

Internationally, England fares better in cancer treatment than France, Spain or Germany, but falls behind Sweden and the Netherlands.

Among its recommendations, the NAO suggested that GPs have better guidance on referring patients, allowing a better chance of early treatment.

Conservative chairman of the Commons public accounts committee and Edward Leigh said the report "depressingly confirms the existence of a cancer health divide".

"Those on the wrong side of it are likely to live in areas of higher deprivation which have higher rates of incidence of cancer and of death from the disease," he said.

Reaction

The report has been welcomed by the government's national cancer director, Professor Mike Richards.

"The cancer plan recognised that the poor are more likely to get cancer than the rich, and their chances of survival are lower and committed to tackling this," he said.

"Much of the action on cancer prevention is concentrated in areas of high social deprivation. Now that 99 per cent of patients with suspected cancer are seeing a specialist within two weeks of being urgently referred by their GP we are starting to focus on the next stages.

"In some areas of the country new ways of getting patients diagnosed more quickly are being developed and we are starting to see some really significant improvements as a result."

But hadow health secretary Tim Yeo said the government still needs to do more.

"Although it is fantastic that measures introduced by both governments over the last decade has meant that more patients are surviving cancer, the revelations of health inequalities, postcode prescribing and staff shortages make the report harrowing reading," he said.

"It is truly shocking that such a health divide still exists between the rich and poor.

"Especially in areas of deprivation, the government must do much more, not only to raise awareness of cancer, but also of the health-related dangers of bad diet and smoking."