Our response to the National Bowel Cancer Audit findings
Yesterday findings from the annual National Bowel Cancer Audit were published. The audit, which aims to improve patient care, measures and compares the diagnosis, treatment and outcomes of over 30,000 bowel cancer patients across England and Wales and suggests changes to improve care for people with the disease in the future. It’s only by looking at what is working successfully and what works less well, that problems can be identified and evidence-based recommendations can be made.
Key points from the audit include:
- Patients diagnosed through the National Bowel Cancer Screening Programme are more likely to be diagnosed at an early stage of bowel cancer compared to patients diagnosed as an emergency. 23% of patients aged 60-74, and therefore eligible, were diagnosed via screening. Over half of patients (54%) were diagnosed following a GP referral and a further 20% of patients were diagnosed in an emergency presentation such as A&E.
- Only 2% of patients diagnosed with bowel cancer between 1 April 2016 and 31 March 2017 died within 90 days of major surgery. This is a slight improvement from last year (3%).
- The use of keyhole surgery has increased by 4% since last year. Nearly 60% of patients having major surgery to remove their tumour are operated using this less invasive approach, which tends to have a shorter recovery time.
- Two thirds (66%) of all bowel cancer patients survive beyond two years. This has remained stable since 2012/13.
Deborah Alsina MBE, Chief Executive of Bowel Cancer UK, says:
“While it is encouraging to see two year survival rates have not dropped, there is still more work to be done to ensure that survival increases over time and early diagnosis is critical to achieving this.
“The audit shows that the proportion of screen detected cancer in those of screening age has remained unchanged from the previous year at 23%, however this varies hugely across England and Wales. Yet we know screening gives the best chance of an early diagnosis, with more than nine in 10 surviving if diagnosed at the earliest stage. With the introduction of the new easier to use faecal immunochemical test (FIT) in the screening programme, we know that screening uptake will improve but this must be a clear focus including across all socio economic groups to ensure inequalities are addressed.
“We must also urgently address how diagnostic workforce can be increased and staff trained, so that we can save more lives by diagnosing people earlier and support the increased demand from necessary improvements to the bowel cancer screening programme.
“Furthermore, emergency presentation is still a huge area of concern, with 20% still being diagnosed in this setting. The audit categorically shows that outcomes for these patients are considerably poorer than those diagnosed through screening. They are less likely to be treated with curative intent, more likely to be diagnosed at the later stages of the disease and as a result have poorer survival chances. If survival rates are to be transformed, it is imperative that we ensure that emergency presentation is reduced.”