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Cheshire & Merseyside Bowel Cancer Screening Programme April 2008. Cancer Reform Strategy Changes. Extending screening from 2010 to 70-74 year olds 62 day waits to apply – end 2008 Consideration of people in their 50s is next step Flexi-sig trial results will be available in 2/3 years
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Cheshire & Merseyside Bowel Cancer Screening ProgrammeApril 2008
Cancer Reform Strategy Changes • Extending screening from 2010 to 70-74 year olds • 62 day waits to apply – end 2008 • Consideration of people in their 50s is next step • Flexi-sig trial results will be available in 2/3 years • Immunological testing and CT colography to be considered in due course
Cheshire & Merseyside Programme • Total population of 2.38 million • Screening population of 330,000 • Working across 8 Primary Care Trusts • 18 PCT-based clinics • 11 colonoscopy lists per week at RLH, Aintree and Leighton
Cheshire and Merseyside BCSP Clinical Statistics fromSeptember 2006- March 2008 • Overall Uptake rate 55% • 1268 patients seen in nurse led clinics following FOB positive result • 1215 colonoscopies performed • 38 patients refused to have colonoscopy (2.6%) • 31 patients deemed clinically inappropriate (2.1%) • 15 patients had completion barium enema (1%)
NEOPLASIA • Total number of adenomatous polyps removed = 1330 (498 patients ) • Total number of hyperplastic polyps removed =314 • Total number of malignant polyps removed= 21 patients
Patient Outcomes • 10% patients to have 1 year surveillance (High risk polyps) • 18% patients to have 3 year surveillance (Intermediate risk polyps) • 60% to return to screening programme with 2 yearly invitation to repeat participation in screening ( Low risk polyps) • 12% referred to local MDT for cancer treatment ( 141 patients )
Duke Staging of CRC on BCSP • Duke A 53% (including malignant polyps) • Duke B 21.4% • Duke C 21.4% • Duke D 4.2% • These figures are based upon 115 patients who had undergone surgery at time of audit and had definitive post-operative staging.
Central and Eastern Cheshire PCT Screening Uptake • Total screening population 65,134 • April - June 07 = 40.0% • July - Sep 07 = 56.00% • Oct - Dec 07 = 59.00% • Jan - March 08 = 60.00%
Central and Eastern Cheshire PCT Activity • April 2007 _ March 2008 • Total invitations sent 29,872 • Self Referrals (over 70’s) 736 • FOB Positive patients 290 • Nurse Clinic Attendance 216 • Colonoscopy Performed 213 • (including surveillance )
Central and Eastern Cheshire PCT • Adenomas removed from patients = 99 • Cancers detected = 27
CENTRAL AND EASTERN CHESHIRE PCT DUKES CLASSIFICATION • DUKES A = 53.8% • DUKES B = 46.2% • DUKES C = 0% • DUKES D = 0% • Total number of MDT referrals to date = 23
WESTERN CHESHIRE PCT SCREENING UPTAKE • Total screening population 35,470 • July - Sep 07 = 49.00% • Oct - Dec 07 = 56.00% • Jan - March 08 = 59.00%
Western Cheshire PCT • July 2007 _ March 2008 • Total invitations sent 14,825 • Self Referrals (over 70’s) 431 • FOB Positive patients 145 • Nurse Clinic Attendance 95 • Colonoscopy Performed 87 • (including surveillance )
Western Cheshire PCT Activity • Adenomas removed from patients = 34 • Cancers detected = 12
WESTERN CHESHIRES DUKES CLASSIFICATION • DUKES A = 87.5% • DUKES B = 0% • DUKES C = 12.5% • DUKES D = 0% • Total number of MDT referrals to date = 18
RLBUH DUKES CLASSIFICATION • DUKES A = 52.17% • DUKES B = 8.69%% • DUKES C = 34.8% • DUKES D = 4.34% • Total number of MDT referrals to date = 31
UHA DUKES CLASSIFICATION • DUKES A = 53.3% • DUKES B = 20.0% • DUKES C = 26.7% • DUKES D = 0% • Total number of Liverpool MDT referrals to date = 23 (Sefton patients not included = 6)
Further Information • www.cancerscreening.nhs.uk • www.bcsp.nhs.uk • www.endoscopy.nhs.uk • www.grs.nhs.uk • www.thejag.org.uk • www.doh.gov.uk