Murcia doctor denounces cancer screening delays, warns patients face preventable deaths

Alejandro Pérez has spent three years as the cancer screening coordinator for Area IX of Murcia's regional health system, a district covering three small towns in the southeast of Spain. He is a gastroenterologist at the Hospital de la Vega Lorenzo Guirao in Cieza. Last month, he resigned.

The reason is simple and devastating: people are dying from preventable cancers because they cannot get timely diagnoses. The screening protocol is straightforward. Patients over fifty receive an invitation to take a fecal occult blood test. If that test comes back positive, they should receive a colonoscopy within one month—or six weeks at the absolute maximum under national guidelines. In Area IX, the wait is now three to four months. More than thirty patients are currently in that queue, watching time pass.

Pérez understands what those months mean. A cancer that could have been caught and removed while still localized becomes something else entirely. It metastasizes. It becomes inoperable. What was preventable becomes terminal. He has seen this happen repeatedly. He has documented it. He has reported it to hospital leadership and to the regional health authority. The response has been silence.

The problem is not new. Pérez arrived three years ago to find screening delays already embedded in the system. They have only worsened since. The root cause, he explains, is structural: the population in Area IX is aging, like much of Spain. Demand for medical services rises. The number of doctors does not. His department has four physicians. They have been requesting additional staff for years—before Pérez arrived and continuously since. No reinforcements have come. No new contracts have been offered to the region despite open positions elsewhere in the health system.

But the cancer screening failures are only part of what drove Pérez to leave. The other part concerns patients with cirrhosis of the liver. This is a chronic, fatal disease. The only cure is transplant. These patients face a severe risk of developing liver cancer from the underlying damage—whether from hepatitis, alcohol, or other causes. Standard practice across Spain is to monitor them with ultrasound every six months. In Cieza, this does not happen on schedule. Pérez has patients who arrived at his clinic more than a year late for their monitoring scans. By the time they reach him, the cancer is already advanced beyond treatment. They are, in his words, destined to die. There is nothing curative medicine can offer them.

This too has been reported. This too has been met with inaction.

Pérez is leaving the hospital and entering the job market without unemployment benefits. He could not stay. "To work poorly, I prefer not to work," he said, "because it will cost me my life in another way." What he means is the weight of it—the shame of telling patients that their diagnosis came too late, that treatment is impossible, that the delay was not their fault. He has wanted to tell some of them: if you had been born in Murcia city, or Cartagena, or Lorca, this would not have happened to you. Geography should not determine whether your cancer is caught in time.

The regional health authority responded to his allegations by stating that colorectal cancer screening is operating normally in Area IX and that screening coverage is complete for the fifty-to-sixty-nine age group across the entire region. They noted that follow-up care for cirrhosis patients is provided according to individual clinical need. They did not address the three-to-four-month wait times. They did not explain the staffing shortage. They did not say when additional resources might arrive.