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National Bowel Cancer Audit Report

Wednesday, November 30, 2011

The lives of more bowel cancer patients could be saved if the NHS made more consultants available in emergencies and cancers were detected earlier, experts have said.

The president of the Royal College of Surgeons (RCS) said too many patients were dying following emergency surgery for the disease.

He was responding to an England and Wales audit of bowel cancer care which showed 11.2% of patients undergoing emergency surgery die, alongside 6% of those having urgent surgery.

Bowel cancer is often only detected at a late stage, frequently when a tumour causes a life-threatening emergency bleed or blockage.

The report covers data from 100 NHS trusts and includes more than 28,000 cases of bowel cancer. Some form of surgical procedure was performed in 75% of cases and a major resection - removal of all or part of the bowel - was undertaken in 60% of patients.

But the study said delays in diagnosis were having an impact on surgery rates. "Late presentation of the disease may be the reason why almost 40% of patients do not receive major surgical resection of their primary disease," it said.

It added that resection rates in England and Wales "certainly lag behind" Australia, Canada and the Scandinavian countries. Major surgery carried out as an urgent or emergency procedure also varies by trust - from over 45% in Avon, Somerset and Wiltshire to just over 10% in North Trent.

There was some good news in the study - the overall number of patients who die within 30 days of planned surgery has fallen, to 2.4% in the 12 months to July 2010 from 2.6% in the previous year. The use of keyhole surgery, which is less invasive, is also becoming more widely used, accounting for 30% of cases compared with 25% the year before.

Professor Norman Williams, president of the RCS, said it produced a report last month on the failings of the NHS in effectively treating emergency patients, including those with bowel cancer.

"The NHS could be doing a lot more to organise in a way that gets these very sick patients in the care of a consultant surgeon earlier on their arrival at hospital. We would encourage commissioners to find out if their local hospital is following Royal College of Surgeons standards for emergency care."