National audit shows bowel cancer care is improving

In collaboration with the Press Association

An in-depth report about bowel cancer surgery in England and Wales has found that care is improving for the disease.

But patients who receive emergency surgery continue to fare less well than those whose operations are pre-planned.

Emergency surgery tends to be more common in people who are diagnosed late, when the disease is more advanced.

The latest report from the National Bowel Cancer Audit - published by the NHS Information Centre and others - looked at the management of more than 28,000 cases of bowel cancer in England and Wales from August 2009 to July 2010.

The findings show that mortality rates have continued to improve among patients who undergo less urgent elective or scheduled operations.

Almost one in three patients received keyhole surgery - a less invasive operation performed through a small cut in the belly - an increase from one in four the previous year.

This is thought to be the result of a national training programme that's been underway in recent years to update the skills of bowel surgeons.

But the report found that patients who received urgent and emergency surgery had a higher death rate in the 30 days after their operation.

Researchers also looked in detail at surgery for two of the main types of bowel cancer - rectal cancer and colon cancer.

They found that there was a higher death rate among colon cancer patients within 30 days of major surgery, with 4.2 per cent dying compared with 2.5 per cent of rectal cancer patients.

Rectal cancer patients were also less likely to undergo a major surgical procedure or emergency surgery than colon cancer patients, partly because rectal cancer is often detected at an earlier stage.

Responding to the audit, Nigel Scott, President of the Association of Coloproctology of Great Britain & Ireland, said: "We welcome the increasing success of colorectal surgeons, specialist nurses, oncologists and other medical specialties.

"However, advanced emergency presentation of bowel cancer remains a concern. All too often worries are locked behind the bathroom door because of embarrassment until the problem is too advanced to be retrievable.

Sarah Woolnough, Director of Policy at Cancer Research UK, also welcomed the report. She said: "Bowel cancer is the third most common type of cancer in the UK, so it's encouraging to see that care is improving.

"But this report also highlights the importance of people knowing the potential symptoms of bowel cancer, such as loose stools or blood in stools, as when the disease is diagnosed at the earliest stage there is a good chance of survival.

"Raising awareness about bowel cancer symptoms could also encourage people to take up their invitation for bowel screening and improve early detection of the disease."

Copyright Press Association 2011