NBOCA (National Bowel Cancer Audit) is a high-profile, collaborative, national clinical audit for bowel cancer, including colon and rectal cancer, run jointly by NHS Digital, the Clinical Effectiveness Unit at the Royal College of Surgeons, and ACPGBI.
The National Bowel Cancer Audit (NBOCA) now has a standalone website where you can access interactive trust results, reports, news and information about the audit. Search for your trust /site under the Trust results section and you will find the results for your trust /site and be able to compare your trust’s outcomes to all other trusts in England and Wales.
This ninth annual report from the National Bowel Cancer Audit is the most up to date information from England and Wales regarding the care and outcomes of bowel cancer patients. The report reflects an enormous amount of hard work in collecting, analysing and interpreting a mass of data and I am extremely grateful to all those individuals involved – English trusts, Welsh Health Boards, NHS Digital and the Clinical Effectiveness Unit at the Royal College of Surgeons of England.
This year’s audit report also contains some encouraging trends; mortality rates following both elective and emergency surgery have fallen over the past five years and there are increased numbers of operations being performed laparoscopically. The 90-day mortality after elective major resections has improved from 2.9% to 2.0%, plateauing over the last few years, and the 90-day mortality after emergency major resection has improved from 16.3% to 11.5%.
One quarter of eligible patients were diagnosed through the Bowel Cancer Screening Programme; this figure is stable but needs to increase and the uptake of screening across the country continues to vary considerably. Active promotion of the NHS Bowel Cancer Screening Programme needs to continue.
This year’s report has also described geographical variation in chemotherapy administration and further work is required to better describe and understand this. It is encouraging to see that there has been a reducing trend of deaths in hospital from 2011 to 2016 (46.2% – 34.6%), but proportions of home deaths remain short of what we know is most patients’ wishes.
The audit is now linked to the National Emergency Laparotomy Audit (NELA) and this report presents some initial findings. Further work is planned in order to better understand the management of bowel cancer patients presenting as an emergency. As the audit continues to widen its coverage of the patient pathway it has looked at variation in place of death.
Complete and accurate data remain the key requirement to describe processes and outcomes of care for all patients with bowel cancer. The clinical ownership and oversight of the data submitted by each English trust/Welsh MDT is crucial. It remains our responsibility to provide accurate and up to date information to those diagnosed and undergoing treatment for bowel cancer. The value of the annual report remains dependent on the quality of data submitted by the contributing multi-disciplinary teams.
Once again, a separate patient report summarising the key findings of the 2018 Annual Report has been produced.