Concern over delays in bowel cancer patients seeking help

One in five is admitted as an emergency, presenting with severe and potentially life-threatening conditions, according to the National Bowel Cancer Audit.

Of 29,000 bowel cancer patients diagnosed in England and Wales between 2010 and 2011, 21.2 oer cent were admitted as an emergency.

Nearly a third of these were not suitable for surgical intervention, meaning their cancer was already too advanced to be operated on, according to the data from the Health and Social Care Information Centre (HSCIC). Of those who were operated on, 11.9 per cent died within 90 days of surgery. Five per cent of more than 17,000 patients diagnosed in 2010-11 and who underwent surgery for the condition died within 90 days of their operation in England and Wales, down from 6.4 per cent in 2007-8.

But the Audit shows mortality rates at Scarborough Hospital rose to one in nine patients who died within three months of surgery and nearly one in 10 at Barnsley and Rotherham hospitals also died within 90 days.

In contrast, only 1.4 per cent of patients treated at Airedale Hospital, near Keighley, died within three months, eight times fewer than in Scarborough. Deaths were also below the national average at the Bradford, Mid Yorkshire, Doncaster and Bassetlaw, and Sheffield trusts.

The report found emergency admissions of patients with the condition remained a “major cause of concern”.

Bowel cancer is the third most common form of the disease in the UK, with 41,000 cases diagnosed each year, and the second commonest cause of cancer death, claiming 16,000 lives a year, but many are diagnosed too late for effective treatment.

Overall the audit looked at 29,000 bowel cancer cases diagnosed in 2010-11.

Colorectal surgeon Nigel Scott, who led the audit audit, said emergency admissions for the cancer were a “persistent and very significant health problem” and urged people to come forward earlier if they had symptoms.

“Symptom awareness campaigns are useful to break down the taboos of bottoms and bowels that lock these symptoms behind the bathroom door. But emergency surgery continues to be the Cinderella of surgical practice in the UK,” he said.

“A recent survey of surgeons highlighted that the NHS pressures currently work against emergency cases with 55 per cent of surgeons describing inadequate emergency theatre access.”

He said only one in six emergency surgeons had access to a comprehensive interventional imaging service out of hours which had a “major detrimental effect” on work during surgery.

David Peverelle, chief operating officer at Barnsley Hospital said: “Any higher than expected death rate at the hospital is unacceptable which is why we asked for an independent review earlier this year. The analysis, carried out by a specialist medical examiner, confirmed that Barnsley Hospital is a safe hospital and the care delivered here is of a high standard but there were some actions, particularly around how we record deaths, that were needed. These are already under way and we anticipate that future rates will be lower.”

Officials at Rotherham and Scarborough hospitals were “unable to comment” on the figures.

The audit showed numbers of patients given keyhole surgery rose 25 per cent to two in five operations in the three years to 2010-11. The procedure is linked to a shorter hospital stay of six days compared to nine days for open surgery and a significantly reduced risk of post-operative death although the technique is usually planned in advance and performed on fitter patients with less advanced disease

Public Health Minister Anna Soubry said: “It is encouraging that bowel cancer survival is increasing but numbers being first diagnosed via A&E are concerning.”