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The NHS Bowel cancer screening programme achieves the anticipated survival improvement, but participation must be improved

David W. Borowski (University Hospital North Tees, Stockton on Tees, UK)
Sarah Cawkwell (University Hospital North Tees, Stockton on Tees, UK)
Syed M. Amir Zaidi (University Hospital North Tees, Stockton on Tees, UK)
Matthew Toward (University Hospital North Tees, Stockton on Tees, UK)
Nicola Maguire (University Hospital North Tees, Stockton on Tees, UK)
Dharmendra K. Garg (University Hospital North Tees, Stockton on Tees, UK)
Talvinder S. Gill (University Hospital North Tees, Stockton on Tees, UK)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 12 March 2018

300

Abstract

Purpose

The NHS Bowel cancer screening programme (NHSBCSP) aims to reduce colorectal cancer (CRC) cumulative mortality by up to 23 per cent; long-term outcomes at national level are not yet known. The purpose of this paper is to examine a local population of CRC patients of screening age for their characteristics and long-term survival in relation to their presentation, including through the NHSBCSP.

Design/methodology/approach

Retrospective analysis of a prospectively maintained CRC database for the years 2009-2014 in a single district hospital providing bowel cancer screening and tertiary rectal cancer services.

Findings

Of 528 CRC patients diagnosed in the screening age range, 144(27.3 per cent) presented through NHSBCSP, 308(58.3 per cent) electively with symptoms and 76(14.4 per cent) as emergency. NHSBCSP-diagnosed patients were younger (median 66 vs 68 and 69 years, respectively, p=0.001), had more often left-sided cancers (59(41.0 per cent) vs 82(26.6 per cent) and 24(31.6 per cent), respectively, p=0.001), more UICC-stage I (42(29.2 per cent) vs 49(15.9 per cent) and 2(2.6 per cent)), stage III (59(41.0 per cent) vs 106(34.4 per cent) and 20(26.3 per cent)) and less stage IV disease (8(5.6 per cent) vs 61(19.8 per cent) and 34 (44.7 per cent), respectively, p<0.001). Three-year overall survival was best for NHSBCSP and worst for emergency patients (87.5 per cent vs 69.0 per cent and 35.3 per cent, respectively, LogRank p<0.001).

Originality/value

Patients diagnosed within the NHSBCSP have improved outcome compared to both symptomatic elective and emergency presentations. A reduction in overall cumulative mortality in order of 25 per cent may well be achieved, but continuing high levels of emergency presentations and undetected right-sided disease emphasise need for further improvement in public participation in the NHSBCSP and research into more sensitive and acceptable alternative screening methods.

Keywords

Citation

Borowski, D.W., Cawkwell, S., Zaidi, S.M.A., Toward, M., Maguire, N., Garg, D.K. and Gill, T.S. (2018), "The NHS Bowel cancer screening programme achieves the anticipated survival improvement, but participation must be improved", International Journal of Health Care Quality Assurance, Vol. 31 No. 2, pp. 106-115. https://doi.org/10.1108/IJHCQA-11-2016-0169

Publisher

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Emerald Publishing Limited

Copyright © 2018, Emerald Publishing Limited

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