The National Bowel Cancer Audit shines spotlight on status of bowel cancer care
Wednesday 14 February 2024
The findings from the National Bowel Cancer Audit’s (NBOCA) State of the Nation report have been published. The audit measures and compares the diagnosis, treatment, quality and outcomes of care for over 35,000 bowel cancer patients across England and Wales. The report makes recommendations to health bodies to allow them to understand where variations in care exist, and where improvements can be made.
The audit includes data on people diagnosed with bowel cancer between 1 April 2021 and 31 March 2022.
Key points from the audit include:
- 42% of bowel cancers were diagnosed at stages 1 and 2 in England and Wales in 2021/22. While this is an improvement from 35% in 2017/18, it is still far behind the Government ambition of 75% of all cancers to be diagnosed at these earlier stages by 2028 in England
- The audit found that 27% of newly diagnosed bowel cancer patients were tested for Lynch syndrome in 2021/22, compared with 14% in 2018/19. This increase corresponds with the findings of our recent report into Lynch syndrome services. However, the National Institute for Health and Care Excellence (NICE) recommends that all patients newly diagnosed with bowel cancer should undergo genetic testing for Lynch syndrome
- Almost half (44%) of providers are not meeting the target of reversing patients’ ileostomy within 18 months of surgery. This is a substantial reduction since pre-pandemic levels in 2019/20, showing that performance has not yet recovered. Unclosed ileostomies can affect people’s quality of life and can occasionally cause further complications for patients. NBOCA suggests that tackling waiting lists must be a key focus of improvement
- Access to a clinical nurse specialist (CNS), an important component of patient care, was only met by 37% of providers
- There has been a reduction in overall 90-day post-operative mortality (any death following a major surgery within 90 days of the procedure) from 3.1% in 2017/18 to 2.4% in 2021/22
Dr Lisa Wilde, Director of Research and External Affairs at Bowel Cancer UK, says: “This report provides an important insight into the quality of bowel cancer services throughout England and Wales, and the impact this is having on patient experience and wellbeing.
“It's encouraging to see an increase in the number of patients being tested for Lynch syndrome. This ensures that those who test positive can receive personalised treatment.
“We know that early diagnosis for bowel cancer is key, as this is when the disease is easier to treat. While it’s positive to see in the NBOCA report that there has been a slight increase in the numbers of patients diagnosed with bowel cancer at stages 1 and 2, there is still room for much improvement.
“We want all bowel cancer patients to receive the best treatment and care available, but staff shortages and lack of capacity continue to be the biggest barrier to making this a reality. It’s vital that we see a commitment to improve this.”
- Learn more about our policy and campaigning work
- Find out how we can support you with subjects covered in this report
- Become a campaign supporter to help lead the change and improve early diagnosis of bowel cancer
- Read our five-year strategy that aims to ensure more people are diagnosed at the earliest stages when the disease is easier to treat
