Population-based audit of colorectal cancer management in two UK health regions

• Published in: British journal of surgery 1997-12, Vol.84 (12), p.1731-1736
• Main Authors: Mella, J., Biffin, A., Radcliffe, A. G., Stamataki, J. D., Steele, R. J. C.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Medical sciences; Stomach, duodenum, intestine, rectum, anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1046/j.1365-2168.1997.02869.x

Background To obtain information on the contemporary management of colorectal cancer in the UK to assist in the development of management guidelines, an independent, 1‐year population audit was carried out in Trent Region and Wales. Methods Data were collected on all patients admitted to hospital with a new diagnosis of colorectal cancer in a 1‐year period. Results Of 3520 patients, 3221 (91·5 per cent) had surgery. Emergencyhrgent operations were carried out as the first procedure in 552 (17·1 per cent). Resection of the primary disease was achieved in 2859 (81·2 per cent) and this was deemed curative in 2070 (5843 per cent). Twenty‐one per cent of all patients had metastatic disease at presentation. Overall, 30‐day operative mortality was 7·6 per cent (21·7 per cent for emergencyhrgent and 5·5 per cent for scheduled/elective procedures). Anastomotic dehiscence occurred in 105 patients (40‐9 per cent); this was 3·9 per cent after colonic resections and 7·9 per cent after anterior rectal resections. Elective rectal excision resulted in a permanent stoma in 486 of 1054 patients (46 per cent). Conclusion This initial report from a comprehensive, independent audit of colorectal cancer management shows improvement in some aspects of treatment as evidenced by improved anastomotic dehiscence and stoma rates when compared with previous studies. However, there has been little improvement in the proportion of patients presenting with advanced disease, and curative resection rates remain low.