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THE NATIONAL HEALTH SERVICE COLORECTAL CANCER SCREENING PROGRAMME; ITS EFFECT ON THE WORK LOAD OF COLORECTAL SURGICAL UNITS
Author(s) -
Her J. M.,
Stebbings W. S.,
Sargen K.,
Wharton R. Q.,
Kapur S.,
Speakman C. T.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04915_34.x
Subject(s) - medicine , colorectal cancer , pouch , rectum , ascending colon , surgery , stage (stratigraphy) , colostomy , colectomy , colorectal surgery , anastomosis , fistula , general surgery , sigmoid colon , cancer , abdominal surgery , paleontology , biology
The NHS Bowel Cancer Screening Programme (NHSBCSP) has been running since September 2006. Its impact on the workload of colorectal units has not currently been assessed. Aims: To determine the initial increased in workload resulting from screen detected cancers detected by the NHSBCSP. Methods: Cancers detected by the local NHSBCSP were reviewed with respect to: operative intervention, Dukes’ stage, post operative complications, and neo‐adjuvant therapy. Results: Between September 2006 to Jan 2008 100 screen detected cancers were identified. Twenty eight were located in the rectum, 38 sigmoid colon, 2 descending colon, 9 transverse colon, 10 ascending colon, and 13 within the caecum. Of the 100 cases 18 were polyp cancers, 3 of which proceed to a subsequent resection, (2 anterior resections and 1 right hemicolectomy). Of the remaining 82 cases 38 patients had an anterior resection, 26 right hemicolectomy, 5 abdominal perineal resection, 3 sigmoid colectomy and 1 subtotal colectomy. Nine patients had no operative intervention; 5 due to metastatic disease and 4 as a result of patient choice. Thirty five patients had Dukes’ stage A, 31 Dukes’ B, 17 Dukes’ C, and 5 Dukes’ D. There were 8 major post operative complications: 6 anastomotic leaks, 1 colo‐pouch‐vaginal fistula, and one death. Two patients who underwent resections for polyp cancers failed to have the polyp scar removed at the time of surgery. Conclusion: The local NHS colorectal cancer screening programme has resulted in a significant shift towards Dukes’ stage A and B cancers at time of presentation. However it has resulted in a dramatic increase in the number of colorectal resections, 76 between September 06 to Jan 2008.