It’s not the easiest of subjects, but we need to talk about the early detection of bowel cancer.
The annual report from the National Bowel Cancer Audit, published today, shows a continuing high mortality rate of 6 and 11.2% for urgent and emergency surgery for bowel cancer.
Today’s report is based on, for the first time, submissions from 100% of trusts, and reports on the management of over 28,000 cases of bowel cancer during the 12 month period ending July 2010.
While the overall picture of care for bowel cancer patients in England and Wales continues to improve, patients who undergo urgent and emergency surgery are still at a much greater risk of death compared to those who have elective and scheduled procedures.
The real problem is late presentation, which is why the Department of Health’s Bowel Awareness Campaign, starting in January 2012, needs the support of every colorectal surgeon in the country to ensure it has the maximum impact locally.
But it is also about how we manage our cases and the need for:
· prompt and senior involvement with acute cases of bowel cancer; and
· implementation of modern management protocols for those patients presenting acutely.
Many more bowel cancer patient lives could be saved if the NHS made more consultant time available for emergencies and new techniques were more widely used.
An innovation that could help improve care is colonic stenting. This technique enables a bowel blocked by a tumour to be opened by inserting a device. This temporary measure buys vital time for the patient to be stabilised, prepared for surgery and for the expert team to be assembled.
A trial is currently underway to prove the safety and value of this approach - the Royal College of Surgeons (RCS) and Association of Coloproctology of Great Britain and Ireland are encouraging as many hospitals as possible to sign up as participation gives surgeons the back up of training and a support network so the technique can be introduced safely for patients.
The NHS could also be doing a lot more to organise how these very sick patients get the care of a consultant surgeon, consultant anaesthetist and the wider team, and access to high dependency and other facilities, from the moment they arrive at hospital and at any time of the day or night, including weekends. The RCS is encouraging commissioners to ensure their local hospital is following the RCS standards for emergency care.
Read more on the National Bowel Cancer Audit 2011.
Read more on the CREST colonic stenting trial, being run from the University of Birmingham.
Read more on the RCS emergency surgery standards.
See the Department of Health’s campaign on Bowel cancer awareness.
The National Bowel Cancer Audit Project is a collaborative, national clinical audit for bowel cancer run jointly by The NHS Information Centre and the Association of Coloproctology of Great Britain and Ireland.
