Cheshire & Merseyside BowelCancer Screening Programme April 2008Cheshire & Merseyside BowelCancer Screening Programme April 2008
Cancer Reform StrategyChangesCancer Reform StrategyChanges
•Extending screening from 2010 to 70-74year olds•Extending screening from 2010 to 70-74year olds
•62 day waits to apply – end 2008•62 day waits to apply – end 2008
•Consideration of people in their 50s is nextstep•Consideration of people in their 50s is nextstep
–Flexi-sig trial results will be available in 2/3years–Flexi-sig trial results will be available in 2/3years
•Immunological testing and CT colographyto be considered in due course•Immunological testing and CT colographyto be considered in due course
Cheshire & MerseysideProgrammeCheshire & MerseysideProgramme
••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 ClinicalStatistics fromSeptember 2006- March 2008Cheshire and Merseyside BCSP ClinicalStatistics fromSeptember 2006- March 2008
•Overall Uptake rate 55%•Overall Uptake rate 55%
•1268 patients seen in nurse led clinics following FOBpositive result•1268 patients seen in nurse led clinics following FOBpositive result
•1215 colonoscopies performed•1215 colonoscopies performed
•38 patients refused to have colonoscopy (2.6%)•38 patients refused to have colonoscopy (2.6%)
•31 patients deemed clinically inappropriate (2.1%)•31 patients deemed clinically inappropriate (2.1%)
•15 patients had completion barium enema (1%)•15 patients had completion barium enema (1%)
NEOPLASIANEOPLASIA
•Total number of adenomatous polypsremoved = 1330 (498 patients )•Total number of adenomatous polypsremoved = 1330 (498 patients )
•Total number of hyperplastic polypsremoved =314•Total number of hyperplastic polypsremoved =314
•Total number of malignant polypsremoved= 21 patients•Total number of malignant polypsremoved= 21 patients
Patient OutcomesPatient Outcomes
•10% patients to have 1 year surveillance (Highrisk polyps)•10% patients to have 1 year surveillance (Highrisk polyps)
•18% patients to have 3 year surveillance(Intermediate risk polyps)•18% patients to have 3 year surveillance(Intermediate risk polyps)
•60% to return to screening programme with 2yearly invitation to repeat participation inscreening ( Low risk polyps)•60% to return to screening programme with 2yearly invitation to repeat participation inscreening ( Low risk polyps)
•12% referred to local MDT for cancertreatment ( 141 patients )•12% referred to local MDT for cancertreatment ( 141 patients )
Duke Staging of CRC on BCSPDuke Staging of CRC on BCSP
•Duke A 53% (including malignant polyps)•Duke A 53% (including malignant polyps)
•Duke B 21.4%•Duke B 21.4%
•Duke C 21.4%•Duke C 21.4%
•Duke D 4.2%•Duke D 4.2%
•These figures are based upon 115 patientswho had undergone surgery at time of auditand had definitive post-operative staging.•These figures are based upon 115 patientswho had undergone surgery at time of auditand had definitive post-operative staging.
Central and Eastern CheshirePCT Screening UptakeCentral and Eastern CheshirePCT Screening Uptake
•Total screening population 65,134•Total screening population 65,134
•April -June 07 =40.0%•April -June 07 =40.0%
•July - Sep 07 =56.00%•July - Sep 07 =56.00%
•Oct - Dec 07 =59.00%•Oct - Dec 07 =59.00%
•Jan - March 08 =60.00%•Jan - March 08 =60.00%
Central and Eastern CheshirePCT ActivityCentral and Eastern CheshirePCT Activity
•April 2007 _ March 2008•April 2007 _ March 2008
•Total invitations sent 29,872•Total invitations sent 29,872
•Self Referrals (over 70’s) 736•Self Referrals (over 70’s) 736
•FOB Positive patients 290•FOB Positive patients 290
•Nurse Clinic Attendance 216•Nurse Clinic Attendance 216
•Colonoscopy Performed 213•Colonoscopy Performed 213
•(including surveillance )•(including surveillance )
Central and Eastern CheshirePCTCentral and Eastern CheshirePCT
•Adenomas removed from patients = 99•Adenomas removed from patients = 99
•Cancers detected = 27•Cancers detected = 27
CENTRAL AND EASTERN CHESHIREPCT DUKES CLASSIFICATIONCENTRAL AND EASTERN CHESHIREPCT DUKES CLASSIFICATION
•DUKES A = 53.8%•DUKES A = 53.8%
•DUKES B = 46.2%•DUKES B = 46.2%
•DUKES C = 0%•DUKES C = 0%
•DUKES D = 0%•DUKES D = 0%
•Total number of MDT referrals to date = 23•Total number of MDT referrals to date = 23
WESTERN CHESHIRE PCTSCREENING UPTAKEWESTERN CHESHIRE PCTSCREENING UPTAKE
•Total screening population 35,470•Total screening population 35,470
•July - Sep 07 =49.00%•July - Sep 07 =49.00%
•Oct - Dec 07 =56.00%•Oct - Dec 07 =56.00%
•Jan - March 08 =59.00%•Jan - March 08 =59.00%
Western Cheshire PCTWestern Cheshire PCT
•July 2007 _ March 2008•July 2007 _ March 2008
•Total invitations sent 14,825•Total invitations sent 14,825
•Self Referrals (over 70’s) 431•Self Referrals (over 70’s) 431
•FOB Positive patients 145•FOB Positive patients 145
•Nurse Clinic Attendance 95•Nurse Clinic Attendance 95
•Colonoscopy Performed 87•Colonoscopy Performed 87
•(including surveillance )•(including surveillance )
Western Cheshire PCT ActivityWestern Cheshire PCT Activity
•Adenomas removed from patients = 34•Adenomas removed from patients = 34
•Cancers detected = 12•Cancers detected = 12
WESTERN CHESHIRES DUKESCLASSIFICATIONWESTERN CHESHIRES DUKESCLASSIFICATION
•DUKES A = 87.5%•DUKES A = 87.5%
•DUKES B = 0%•DUKES B = 0%
•DUKES C = 12.5%•DUKES C = 12.5%
•DUKES D = 0%•DUKES D = 0%
•Total number of MDT referrals to date = 18•Total number of MDT referrals to date = 18
RLBUH DUKESCLASSIFICATIONRLBUH DUKESCLASSIFICATION
•DUKES A = 52.17%•DUKES A = 52.17%
•DUKES B = 8.69%%•DUKES B = 8.69%%
•DUKES C = 34.8%•DUKES C = 34.8%
•DUKES D = 4.34%•DUKES D = 4.34%
•Total number of MDT referrals to date = 31•Total number of MDT referrals to date = 31
UHA DUKES CLASSIFICATIONUHA DUKES CLASSIFICATION
•DUKES A = 53.3%•DUKES A = 53.3%
•DUKES B = 20.0%•DUKES B = 20.0%
•DUKES C = 26.7%•DUKES C = 26.7%
•DUKES D = 0%•DUKES D = 0%
•Total number of Liverpool MDT referrals to date = 23(Sefton patients not included = 6)•Total number of Liverpool MDT referrals to date = 23(Sefton patients not included = 6)