POPULATION-BASED AUDIT OF COLORECTAL-CANCER MANAGEMENT IN 2 UK HEALTHREGIONS

Background To obtain information on the contemporary management of col orectal cancer in the UK to assist in the development of management gu idelines, an independent, 1-year population audit was carried out in T rent Region and Wales. Methods Data were collected on all patients adm itted to hospital with a new diagnosis of colorectal cancer in a 1-yea r period. Results Of 3520 patients, 3221 (91.5 per cent) had surgery. Emergency/urgent 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 (58.8 per c ent). Twenty-one per cent of all patients had metastatic disease at pr esentation. Overall, 30-day operative mortality was 7.6 per cent (21.7 per cent for emergency/urgent and 5.5 per cent for scheduled/elective procedures). Anastomotic dehiscence occurred in 105 patients (4.9 per cent); this was 3.9 per cent after colonic resections and 7.9 per cen t 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 colore ctal cancer management shows improvement in some aspects of treatment as evidenced by improved anastomotic dehiscence and stoma rates when c ompared with previous studies. However, there has been little improvem ent in the proportion of patients presenting with advanced disease, an d curative resection rates remain low.