Keyhole surgery for bowel cancer on the up, but not yet available to all
There are now fifteen times more people having keyhole surgery for bowel cancer than there were ten years ago, according to research presented at the NCRI Cancer Conference in Birmingham today (Monday).
The study also shows that the technique means patients recover much faster while fewer suffer serious complications soon after surgery.
The number of bowel cancer patients receiving keyhole surgery rose from 95 in 1998 to 1,491 in 2006.
But the research also revealed that some patients are missing out on these benefits because of variation across England in access to this groundbreaking technique.
These figures are available because of a revolutionary new database created by the National Cancer Intelligence Network (NCIN), which enables researchers to monitor cancer care across the whole of the NHS for the first time.
Lead author Cancer Research UK's Dr Eva Morris, who is based at the University of Leeds, said: "Our results are encouraging. Just a decade after the technique was introduced, fifteen times more people with bowel cancer are now benefiting.
"Our figures came from hospital data, which is often incomplete, so we think the actual number of patients could be even higher.
"The NCIN's new database has allowed us to take a snapshot of keyhole surgery across the UK.
"The hospitals with trained surgeons using the technique are usually in the more affluent areas of the country. We're not yet sure why this is. Our next step will be to look into this inequality.
"Overall, patients who had bowel cancer diagnosed at an earlier stage and fewer associated health problems were more likely to be treated with the technique. This partly explains why generally they did better after the operation.
"It's essential with these new and exciting techniques that surgeons are trained quickly, and our figures show that the national training programme for this particular type of surgery has been successful so far. The technique is, however, relatively new so it's important that its outcomes are monitored."
Patients who were given keyhole surgery usually had less advanced disease and a better prognosis. They were around 30 per cent less likely to die within a month of the operation and were discharged around 3 days earlier from hospital than patients receiving traditional open operations.
Professor Peter Johnson, Cancer Research UK's chief clinician, said: "Cancer surgeons have been active in developing these new techniques and the results are very positive.
"We need to make sure that they are made available to all the patients who might benefit, and Cancer Research UK sees research in cancer surgery as a key priority."
Professor David Forman, information lead for the NCIN and study co-author, said: "Two of the major recommendations in the government's Cancer Reform Strategy were to improve treatment and to develop a world class cancer information system. This piece of work touches on both of these aims.
"Before now, national figures like this weren’t available, so we couldn’t compare care across the NHS.
"Now we have this information, we can drive improvements in cancer care and enhance patient choice."
Professor Mike Richards, National Cancer Director said: "Good progress has been made in the provision of keyhole surgery for bowel cancer over the past three years since the National Institute for Health and Clinical Excellence (NICE) published its technical appraisal*. However, we can and we must go further. The national training programme in laparoscopic colorectal surgery will ensure that patients in all parts of the country can benefit from this new technique."
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Thomas Clarke, Phil Quirke, David Forman, James Thomas, Eva Morris; Trends in laparoscopic colorectal tumour resections across England between 1998 and 2006. NCRI conference 2009.
Notes to Editor
* In August 2006, the National Institute for Health and Clinical Excellence (NICE) issued guidance approving laparoscopic bowel surgery as a possible alternative to traditional open surgery for people with bowel cancer. The NHS aims to offer this procedure in all hospitals by 2012.
The NCIN's newly created National Cancer Data Repository (NCDR) contains information about every cancer patient in England. The data comes from NHS sources like cancer registry data and Hospital Episode Statistics.