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National Bowel Cancer Audit highlights progress – but urgent action still needed

Thursday 9 October 2025

The National Bowel Cancer Audit (NBOCA) published today highlights encouraging progress in bowel cancer care, but urgent action is needed as one in five patients are still diagnosed in an emergency setting.  

The audit’s State of the Nation report explores care received by people diagnosed or undergoing surgery for bowel cancer in England and Wales between 1 January 2023 and 31 December 2023. 

The audit highlights encouraging progress — more people are living longer following major surgery, fewer patients are returning to theatre for additional surgery and keyhole surgery is now being widely used, helping people recover faster. 

However, far too many people are still diagnosed with bowel cancer in emergency settings. While rates of emergency diagnosis have dropped slightly – from 21% in 2019 to 19% in 2023 – this is still almost one in five patients. This often means more aggressive treatment, poorer survival and a greater physical and emotional toll on patients and their loved ones. 

There is also a worrying rise in the number of younger people being diagnosed with bowel cancer. Eight per cent of new cases are now in people under 50, a global trend we’re continuing to address through our Never Too Young campaign. 

The audit also finds significant variation in treatment and care across the country and the need to improve quality of life for people living with and beyond bowel cancer. Only six in 10 NHS trusts met the target for patients having access to a clinical nurse specialist, despite the clear difference this support makes.

Meanwhile, nearly four in 10 patients were still living with a temporary stoma 18 months after surgery, which can have a profound impact on daily life. There remain differences in treatment approaches, including chemotherapy and radiotherapy, depending on where patients are treated. 

Dr Lisa Wilde, Director of Research, Policy and Influencing at Bowel Cancer UK, said: “The latest NBOCA report highlights that hospitals in England and Wales are, overall, performing well when treating people with bowel cancer. However, it also shows that patients’ quality of life during treatment could be improved and highlights a wide variation in treatment and experience nationwide. The number of patients being diagnosed with bowel cancer in emergency settings is still too high. 

“Whilst we welcome the improvements, more needs to be done to improve the quality of life of people living with and beyond cancer. We need greater consistency so that everyone across England and Wales has the same access to best treatment and care.” 

We know that the impact of bowel cancer doesn’t end with treatment. Our services are here to help you with the challenges you face. 

  • Visit our online communities, welcoming places for anyone affected by bowel cancer to get help and support 
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