A fall in overall post-operative mortality rates, improvements in access to multi-disciplinary opinions, increased use of laparoscopic (keyhole) surgery and a recognition that urgent or emergency surgery carries a three fold increase in post-operative death over elective cases are amongst the findings published today in the annual report from the national audit of bowel cancer.

The report, commissioned by the Healthcare Quality Improvement Partnership and published today by The NHS Information Centre on behalf of the Association of Coloproctology of Great Britain and Ireland, gives a detailed appraisal of bowel cancer care in England and Wales. All but three trusts submitted data to the audit which reports on the management of over 23,000 cases of bowel cancer over the one year period from August 2008 to July 2009.

Among its key findings, the report shows:

- Overall participation by trusts has increased to 98 per cent as compared with 95 per cent in 2009.

- Case ascertainment continues to improve with an estimated 74.7 per cent and 97.3 per cent of cases from English and Welsh trusts respectively being submitted.

- Overall post-operative mortality following major resection in elective cases was 2.6 per cent which is an improvement compared with previous years. Post-operative mortality in urgent and emergency cases was 7.7 per cent. Differences were again noted between Networks and Trusts.

- Some form of surgical procedure was performed in 75 per cent of cases and a major resection was undertaken in 60 per cent of patients. Urgent or emergency surgery was performed in 23 per cent of cases.

- Laparoscopic procedures continued to increase, with 25 per cent of cases being completed laparoscopically.

- The proportion of cases discussed at a multi disciplinary team rose to 95 per cent (from 83.7 per cent in the 2009 report) and, where stated, 80 per cent of cases were seen by a nurse specialist (an increase from 51.2 per cent in 2009 report).

Professor Paul Finan, the clinical lead for the audit said: "The national bowel cancer audit has clearly been embraced by almost all trusts within England and Wales and the information obtained should have a direct effect on the management of patients with this common cancer. It is encouraging to see a continued fall in post-operative mortality, but the increased mortality observed when operating in the urgent or emergency situation should prompt particular attention to cases that present acutely. It is hoped that the national bowel cancer screening initiative and earlier recognition of the symptoms of bowel cancer by the public will be reflected in improved outcomes for this disease."

From 7 June the National Bowel Cancer Audit Report can be accessed at www.ic.nhs.uk/bowelreports

Source: NHS – The Information Centre