12 Apr 2011

‘Worrying’ disparities in bowel cancer surgery

A new survey suggests bowel cancer survival could depend on where patients are treated. Campaigner Lynn Faulds Wood tells Channel 4 News the results are an important step to improve patients’ choice.

Bowel cancer report

Researchers from the University of Leeds analysed survival rates of 161,000 patients within 30 days of undergoing major bowel cancer surgery, at 150 hospitals across England between 1998 and 2006.

While the overall percentage of patients who died within 30 days of surgery fell from 6.8 per cent to 5.8 per cent in the nine year period, the study revealed marked differences in the survival rates across England’s hospitals.

Cancer Research UK, who funded the research, said that while treatment services were ‘improving’ the situation was still ‘worrying.’

The research

Bowel cancer is the second biggest cancer killer in the UK. Some 40,000 Britons were diagnosed with the disease in 2008, with eight out of ten cases occurring in patients over 60 yeas old.

While researchers are careful to point out other factors that could affect results, looking at the last three years of the study there were five hospital trusts that had significantly higher death rates, and three with significantly lower ones.

The proportion of patients dying within a month of surgery ranged from 15.6 per cent at Burton Hospitals NHS Foundation Trust to 1.7 per cent at Central Manchester University Hospitals NHS Foundation Trust.

The worst results were recorded at these hospitals:

  • Burton Hospitals – 15.6 per cent
  • The Whittington Hospital – 13.1 per cent
  • The Rotherham – 11.2 per cent
  • Northampton General Hospital – 10.5 per cent
  • Colchester Hospital University – 10.4 per cent

Initial data suggests the five hospitals which appeared to perform poorly had improved, to achieve close to average mortality rates by 2008.

Read more on the survey from the National Cancer Intelligence Network.

Further reading: Cut back on red meat, goverment warns

Opportunity for improvement

Bowel cancer advocate and survivor, TV presenter Lynn Faulds Wood runs the charity Lynn’s Bowel Cancer Campaign. She was diagnosed with bowel cancer 20 years ago and believes she is alive today due to the ‘pure luck’ of having a ‘wonderful’ surgeon.

Faulds Wood told Channel 4 News the data was an important step to achieving patient choice: “For year’s we’ve been hearing about patient choice, but there is no patient choice unless it is informed choice. This data has been provided by the hospitals themselves so they are able to see how well they are performing.

“Every patient has a right to know if their hospital’s surgical team is excellent, good or poor. These results show a large variation in care, patients have the right to know they are going to be treated by people who are as good as they can be. The chances of survival need to be about more than just luck.”

Faulds Wood believes that these audits are extremely valuable because they provide hospitals and primary care trusts with the data they need to see how well they doing, and provide an opportunity to improve their performance.

Bowel cancer is the UK's second largest cancer killer

Explaining the variations

The report notes that the chances of survival are lower in elderly men, people who were ‘worse off’, those who had advanced cancer, other diseases or presented as emergencies.

Paul Finan, study author and consultant colorectal surgeon said he was encouraged by the overall decrease in mortality rates across the country but; “having adjusted for those factors that can affect post-operative mortality, it is a concern that there is significant variation between hospitals.”

The author of the study, Eva Morris and Cancer Research UK’s Bobby Moore, a fellow at the University of Leeds said: “This study examines the overall performance of the English NHS in managing surgically treated bowel cancer patients. It shows that some patients will always be at a greater risk than others but, despite this, the service is improving.”

Further reading: £759 million cancer strategy aims to save 5,000 lives

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