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Up to 10,000 people die of cancer every year due to late diagnoses, according
to the government’s cancer tsar.

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Shares slide on Dubai and Abu Dhabi exchanges despite government attempts to
calm markets by giving backing to banks.

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Public opposition to Afghanistan war demoralising troops on the front line,
military commanders have warned.

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Convicted robber wanted over the murder of four US policemen was granted
clemency by former Arkansas Governor Mike Huckabee.

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Lord Pearson claimed for his £3.7m “second home” while also
living in a 12,000-acre estate in Scotland.

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Patients and doctors to blame for UK’s ‘unacceptable’ record

Up to 10,000 people die needlessly of cancer every year because their condition is diagnosed too late, according to research by the government’s director of cancer services. The figure is twice the previous estimate for preventable deaths.

Earlier detection of symptoms could save between 5,000 and 10,000 lives in England a year, Prof Mike Richards will reveal this week. The higher figure is nearly twice his previous calculation, which put the figure at about 5,000.

Richards has revised up his estimate after studying the three deadliest forms of the disease ‑ lung, bowel and breast cancer ‑ which together kill almost 63,000 people a year.

“These delays in patients presenting with symptoms and cancer being diagnosed at a late stage inevitably cost lives. The situation is unacceptable,” Richards told the Guardian.

New efforts are planned to educate the public about the signs of cancer, tackle the widespread reluctance to tell their GP if they develop symptoms, and improve family doctors’ ability to spot signs of the disease earlier, he added.

Britain is poor by international standards at diagnosing cancer. Richards’s findings will add urgency to the NHS’s efforts to improve early diagnosis.

They also raise further questions about how often family doctors fail to recognise telltale signs.  

Experts say early diagnosis can be the difference between a patient living for a short or long time or deciding whether they need surgery, such as a mastectomy, or not because quick access to surgery, drugs or radiotherapy greatly improves chances of survival.

In an article in the forthcoming British Journal of Cancer, which is published by Cancer Research UK, Richards will say: “Efforts now need to be directed at promoting early diagnosis for the very large number (over 90%) of cancer patients who are diagnosed as a result of their symptoms, rather than by screening.

“The National Awareness and Early Diagnosis Initiative [NAEDI] has been established to co-ordinate and drive efforts in this area. The size of the prize is large – potentially 5,000 to 10,000 deaths that occur within five years of diagnosis could be avoided every year.”

Richards reached his conclusions after analysing one-year survival rates for the three cancers in England and comparing them with those in other European countries in the late 1990s. Previously he had looked at the number of patients who were still alive five years after diagnosis.

One-year survival is now thought to be a much better indicator of whether diagnosis was early or late.

The study focused on Britain’s three biggest cancer killers: lung, which killed 34,589 people in 2007; colon (16,087); and breast (12,082). They account for 40% of the 155,484 cancer deaths in the UK in 2007 and, Richards found, about half of all the deaths that could have been avoided if diagnosis was as good as the best- performing European countries.

Richards found that “late diagnosis was almost certainly a major contributor to poor survival in England for all three cancers”, but also identified low rates of surgical intervention being received by cancer patients as another key reason for poor survival rates.

Research by academics at Durham University led by Prof Greg Rubin has identified five types of delay in NHS cancer care: “patient delay”, “doctor delay”, “delay in primary care [at GPs' surgeries]“, “system delay” and “delay in secondary care [at hospitals]“.

The new initiative is intended to “fix this problem”, helping the UK’s 53,000 GPs improve their ability to identify patients who may have cancer, said Richards.

With smoking in decline “early diagnosis is our next big challenge in cancer and will be crucial in bringing our survival rates up to the best in Europe”,  he added. Prof Steve Field, chairman of the Royal College of GPs, said: “Mike Richards’s latest findings on cancer diagnosis are really important information and reinforce the need for GPs to put a lot of effort into ensuring that patients present [their symptoms] and have access to GPs, and that we pick up the symptoms early on, and also reflect if we can do things even better in this crucial area of healthcare, which we can.

“It’s wrong to blame GPs for all these deaths, as there are many factors involved, including patients not recognising symptoms of cancer and not talking to their GP about them, especially middle-aged men. But I’m sure that we could all at times be more alert to symptoms and investigate and refer patients quicker,” he added.

Sara Hiom, director of health information at Cancer Research UK, said GPs faced a difficult task in spotting cancer: “Despite cancer being a common disease, the average GP will only see one case of each of the four biggest cancers each year.

“Many of the symptoms that could be cancer turn out to be something less serious, but it’s best to get things like unusual lumps, changes to moles, unusual bleeding or changes to bowel motions checked by a GP.”

Early diagnosis usually means that treatment is more effective and milder for the patient, added Hiom.

Katherine Murphy, director of the Patients’ Association, said: “Some patients are diagnosed with cancer when they have presented with the same symptoms six months earlier.

“Patients will sometimes tell us that they had been going to see their GP for six to nine months with, say, a pain in their stomach and were told to go to the pharmacy and buy an over the counter medicine [and later are found to have cancer].”

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• Abu Dhabi stock market fell over 7% when trading began
• More details on rescue plan expected

7.23am: Another important development this morning is that Nakheel, creater of those artificial islands that are shaped like palms, has asked the Dubai authorities to halt trading in three of its bonds, worth a total of $5.25bn. Nakheel asked for the suspension “until it is in a position to fully inform the market” about its restructuring plans.

Thse debts includes Nakheel’s $3.5bn (£2.1bn) sukuk bond which was due for repayment on December 14. The crisis began last week when Nakheel sought a six-month delay on paying off this debt.

Some of the foreign investors who hold a stake in this bond have been urgently seeking legal representation, amid fears that Nakheel might persuade local investors to allow it to default on the debt.

6.50am: As feared, shares have fallen sharply. The Abu Dhabi Securities Exchange Index dropped by 215 points in the first few minutes of trading, down from Wednesday’s close of 2,910 points to around 2,695.

Dubai’s own stock market is down by nearly 6%. And shares in Dubai World have plunged by 15%.

6.00am: Five days ago, the Gulf state of Dubai sparked alarm around the world. The news that state-owned company Dubai World wanted a six-month break from its debt repayments raised the spectre of a meltdown in the luxury playground of the wealthy, possibly leading to a panic that derailed the global economic recovery.

Today, many investors in the Middle East will get their first opportunity to respond to the crisis - as trading has been suspended since the middle of last week for the Eid al-Adha holiday.

We’re also expecting more details from the UAE about exactly what financial support they will give Dubai. Over the weekend, the UAE central bank promised a special liquidity scheme to honour some debts, but on a case-by-case basis.

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Iran today sent a defiant signal to the international community by announcing plans to build 10 uranium enrichment plants days after it was condemned by the UN for concealing activities that are feared may be designed to produce an atomic bomb.

Mahmoud Ahmadinejad’s government said the plants would be the same size as the main enrichment complex at Natanz, central Iran, and work would begin within two months.

“We have a friendly approach towards the world but at the same time we won’t let anyone harm even one iota of the Iranian nation’s rights,” the president said. The aim was to produce 250-300 tonnes of nuclear fuel a year by using centrifuges with a higher speed.

The announcement seems likely to strengthen the hands of those arguing for sanctions if negotiations do not resume soon. The Foreign Office called the development “a matter of serious concern”. The news from Tehran followed Friday’s rare display of unanimity by the security council’s “big five” – the US, Russia, China, Britain and France – who condemned Iran for concealing an enrichment plant in a mountainside near Qom.

The 25-3 vote by the International Atomic Energy Agency, the UN’s nuclear watchdog, was seen as a sign of deepening exasperation over the impasse. Mohammed ElBaradei, the outgoing IAEA chief, warned that talks were at “a dead end”.

As a signatory to the nuclear non- proliferation treaty, Iran has the right to generate nuclear power for peaceful purposes, which is what is says it wants to do. But five UN resolutions demand it suspend enrichment and it is refusing to comply.

Nor is Iran any closer to allaying suspicions it is seeking to secretly build a nuclear weapon. It has been asked by the IAEA to discuss evidence of warhead-related research activities but has refused. Having been caught cheating in the past, its repeated denials have little credibility.

In recent weeks, after talks in Geneva and Vienna with the big five and Germany, Iran has seemed to reject a proposal under which most of its uranium would be shipped to France and Russia for processing into fuel for use in civilian reactors.

An arrangement of that kind would give Iran the nuclear fuel it needs but provide guarantees that it was not being diverted for military purposes.

Analysts and officials suggested the Iranian move was more about making gestures than a realistic plan. “This is mostly about presenting two fingers to the world,” said one diplomat.

Others also pointed to the president’s domestic problems, where he is under pressure from conservatives in parliament, from the supreme leader, Ayatollah Ali Khamenei, and from opposition supporters protesting against the “theft” of last June’s election.

“It’s bluster,” said Sir Richard Dalton, a former British ambassador to Tehran. “Iran can’t afford 10 plants the size of Natanz and 500,000 centrifuges.”

But the move is likely to galvanise efforts to put together a package of sanctions, perhaps persuading Russia and China to back moves supported by the US, Britain and France.

Israel welcomed Friday’s censure by the IAEA but has made clear for months that it reserves the right to take pre-emptive military action if it felt that its own nuclear deterrence were to be challenged by Tehran.

The US warned on Friday that its patience is not unlimited, but doors are being left open in the hope that Iran will somehow re-engage.

Earlier today MPs announced the allocation of $20m for unnamed “progressive” groups to combat what it called US and British “conspiracies.” Iran’s parliament said the money would be disbursed by a committee including representatives of the ministries of intelligence, foreign affairs and the Revolutionary Guards.

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Confidential papers reveal Europeans want assistance for poorer countries to come from existing cash pot

The EU was accused of threatening the global climate talks last night after confidential papers showed it wants existing overseas aid funding to be used to help poor countries adapt to global warming, not new and additional funds.

The papers, seen by the Guardian, show that the EU has removed lines in the negotiating text of next month’s Copenhagen climate change summit which stress the principle that climate change aid comes on top of existing development aid. The EU negotiating team has written: “Cannot accept reference to ‘additional to’, and ’separate from’ ODA [official development assistance] targets.”

Aid agencies said Europe threatened to fatally undermine the talks.

“No developing country will sign up to an agreement that could give them no extra money at all. The EU and other rich countries must provide new and additional finance, otherwise there will be no deal at all,” said Rob Bailey, Oxfam’s senior policy adviser. Developing nations have been unanimous and implacable on the terms of the finance deal.

Rich countries accept they must pay poor ones to adapt to increasing droughts, floods and rising seas, but Europe is known to be split over whether existing aid should provide the cash.

Britain and Holland have argued strongly that it be largely additional, but Germany, France and most small member states have said they want existing aid to be used. In the latter case, spending on poverty, health, water, and education in some of the poorest countries in the world would be significantly reduced. But in a separate development, Britain was embarrassed when it emerged that all the climate aid money it has so far pledged or provided to poor countries has come from its existing aid budget, despite statements by Gordon Brown that it should be largely additional to existing funds.

In an email seen by the Guardian, an official in the Department for International Development (DfID) states: “All of the money pledged, committed, and/or spent [on climate change] thus far comes from within the UK’s 0.7% GNI ODA commitment.”

Britain has pledged nearly £1bn, with most of it channelled into global funds run by the World Bank. But it has separately promised nearly £200m to help especially vulnerable countries such as Bangladesh and Nepal. Earlier this year, Brown said: “The government recognises that finance to tackle climate change cannot simply be part of ODA. [It] should not be allowed to divert money from the pledges we have already made to the poorest.”

On Friday, Brown proposed a new £10bn global fund to kickstart the post-Copenhagen regime. He promised Britain would contribute £800m, although the contribution is expected to be entirely drawn from existing budgets.

Finance now threatens to become the main obstacle to securing a global climate deal at Copenhagen, following US and Chinese moves last week to provide targets for cuts in their emissions.

Poor countries want a minimum of $400bn (£242bn) a year by 2020 to help them adapt, but rich countries have proposed only €110bn (£100bn) a year.

A history of broken promises has seen poor countries become deeply distrustful of climate pledges by rich countries and they say they want guaranteed funding to address the climate change that rich countries have largely caused. Last week, Oxfam stated that only $128m of the money pledged in the last decade by rich countries for adaptation had been handed out, and the UN secretary general, Ban Ki-moon, accused industrialised countries of failing to keep their promises.

Kit Vaughan, the head of climate adaptation at WWF, said: “Gordon Brown was the first leader to step up and call for a global fund to fight climate change, and insisted this shouldn’t come out of existing aid budgets. But so far, all the climate money has come out of the aid budget. Under a Copenhagen deal, it’s crucial to find new and additional money that avoids robbing from the poor.”

Europe, along with other rich countries, has a poor track record on meeting its commitments on climate finance. At a UN meeting in Bonn in 2001, the EU, Canada, Norway, Switzerland, Iceland and New Zealand said they would jointly pay developing countries $410m (£200m) a year from 2005 to 2008. Barely a 10th of the promised money has so far been delivered.A DfID spokesman said: “Additional funding for climate change will be made available from 2013, which is when the commitments from the Copenhagen summit will come into effect. Britain will push at Copenhagen for all countries to provide new and additional finance to tackle climate change.”

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• UK deployment to increase to 9,500
• PM airs frustration with Pakistan’s efforts

Gordon Brown will announce tomorrow that he is sending more British troops to Afghanistan, pre-empting a long-awaited statement from Barack Obama expected on Tuesday.

According to reports in Washington, Obama will announce that 9,000 marines will be sent to Helmand province within days, and the prime minister is expected to confirm that Britain will increase its deployment by at least 500 to 9,500.

Brown will hold a final video conference with Obama tomorrow before the president’s address in the symbolic setting of the West Point military academy at 8pm on Tuesday.

Brown today anticipated what is expected to be one of the main themes of Obama’s statement: Anglo-American frustration at the failure of Pakistan to capture Osama bin Laden and his al-Qaida deputy Ayman al-Zawahiri.

The prime minister told the BBC: “The Pakistan government has started to take on the Taliban and to take on al-Qaida in South Waziristan. But we have got to ask ourselves why, eight years after September 11, nobody has been able to spot or detain or get close to Osama bin Laden, nobody has been able to get close to Zawahiri.

“We have got to ask the Pakistani security forces, army and politicians to join us in the major effort that the world is committing resources to, not only to isolate al-Qaida but to break them in Pakistan.”

Brown, who alerted the Pakistani president, Asif Ali Zardari, to his intervention in a telephone call on Saturday , will make his criticisms directly to the Pakistani prime minister, Yousaf Raza Gilani, in London on Thursday.

Britain has been encouraged by the actions of the Pakistan army in confronting al-Qaida and the Taliban in South Waziristan, where Islamabad has sent 30,000 troops, and in the North-West Frontier province. But officials believe Zardari needs to do more to confront Pakistani state agencies such as the Inter-Services Intelligence (ISI) agency. The ISI encouraged the Taliban in the 1990s and Kashmiri extremist groups.

One diplomat said: “The Pakistanis do not trust the Afghans. They do not trust the Indians. This is how they have done business and that is why we are where we are.”

Islamabad reacted angrily to Britain’s intervention. Wajid Shamsul Hasan, Pakistan’s high commissioner to Britain, told BBC Radio 4: “Our military is fully engaged in these operations, so what do people want?”

Brown, who returned to Britain today from the Commonwealth heads of government meeting (CHOGM) in Trinidad and Tobago, will tell MPs whether his three conditions for further British involvement in Afghanistan have been met. These are that:

• Nato countries other than Britain and the US are sharing the burden.

• Afghan forces are available for British forces to train.

• Ministers are satisfied that troops are properly equipped.

Brown will report progress because non-US Nato countries have committed an extra 5,000 troops. Hamid Karzai, the Afghan president, has agreed to attend a conference in London on 28 January, where he is expected to agree that an extra 5,000 troops will be trained by British troops in Helmand in 2010. Military chiefs have given assurances on equipment.

The prime minister set out at CHOGM a series of benchmarks Afghanistan will have to meet over the next year and which are designed to allow a gradual withdrawal from the end of next year. The benchmarks call for Afghan forces to take the lead in five out of the country’s 34 provinces by the end of 2010.

Brown has been liaising closely with Obama in the run-up to the president’s statement. Simon McDonald, his foreign affairs adviser, has been in Washington as the White House finalises its response to a report by the US commander General Stanley McChrystal. This calls for a surge of around 35,000 troops and a more sophisticated political strategy.

While Britain agrees with much of Obama’s thinking, there is some frustration in London about how long the president has taken to respond to McChrystal. This explains why Brown has had no qualms about making announcements before Obama speaks.

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