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80% of bowel cancer patients who opt for surgery survive two years

But only 43% of patients who do not undergo major surgery survive two years

Ingrid Torjesen

Tuesday, 16 December 2014

Around 80% of patients who have major surgery for bowel cancer survive for two years, according to the National Bowel Cancer Audit, published by the Health and Social Care Information Centre.

Across England and Wales, the two year mortality rate for bowel cancer patients undergoing major surgery was 24%. Wales had a higher than expected adjusted two year mortality rate (27.5%), and Wessex had the lowest adjusted two year mortality rate at 21.2%

Across England and Wales, 66% of colon cancer patients and 80% of rectal cancer patients are still in hospital five days after resection. The strategic clinical networks with  the highest proportion of patients in hospital five days after surgery were Greater Manchester, Lancashire and South Cumbria (78%); Yorkshire and the Humber (76%); London Cancer Alliance (79%) and London Cancer Network (76%). Wessex had the lowest proportion (54%).

The audit report, which looked at data for almost 32,000 bowel cancer patients diagnosed in 2012-13, was commissioned by the Healthcare Quality Improvement Partnership as part of the National Clinical Audit Programme, and developed by the Health and Social Care Information Centre, the Association of Coloproctology of Great Britain and Ireland and the Royal College of Surgeons of England.

According to the report, 90 day post-operative mortality has remained steady at 4.6% after major surgery for colorectal cancer, having fallen from 6.1% in 2008-09. Emergency admission remains at 21% of all cases, and emergency major surgery is associated with a risk of death of 16% at 90 days.

Keyhole (laparoscopic) surgery rates continue to increase, to around 45% of resections in 2012/13, up from 25% in 2008/09.

The audit’s clinical lead, Mr Nigel Scott, a consultant colorectal surgeon at Lancashire Teaching Hospitals Trust, said: "It is a great credit to the hospital teams of surgeons, nurses, oncologists, radiologists, pathologists and many other professionals that 80% of resected cancer patients are surviving to two years.

"Variation in outcome between health units offers a possible insight into how practice might influence outcomes. For example, the substantial regional variation in the percentage of patients still in hospital five days after resection could have significant consequences for hospital expenditure in the NHS.

"There are many potential explanations for variation in two year mortality, including differences in patient characteristics, differences in the completeness and accuracy of data submitted, and differences in the quality of care for people with colorectal cancer, both before and after surgery. We will investigate these potential causes in further detail in next year's National Bowel Cancer Audit."

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