The effects of population-based faecal occult blood test screening upon emergency colorectal cancer admissions in Coventry and north Warwickshire

Stephen J Goodyear ^1*, Ed Leung ¹, Achyuth Menon ², Srinivas Pedamallu ¹, Nigel Williams ¹ and Ling S Wong ¹

¹ University Hospitals Coventry and Warwickshire NHS Trust, United Kingdom
² Kingsmill Hospital, Nottinghamshire, United Kingdom

^* To whom correspondence should be addressed. E-mail: drgoodyear{at}hotmail.com.

Accepted 15 August 2007

Abstract

AimThe English arm of the UK Bowel Cancer Screening Pilot has recently concluded its third round. The primary aim of this study was to assess the effects of this programme upon the emergency and elective cancer workload at University Hospitals Coventry and Warwickshire NHS Trust; the largest trust within the screened region. Our secondary aim was to assess its effect upon Dukes staging, mortality and stoma formation for emergency colorectal cancer (CRC) admissions.

Design: A retrospective analysis of validated data for CRC admissions over a period of six years from 1999 to 2004 was performed. The first year, 1999, represented the pre-screening year (PSY) which was taken as a baseline. Data for the next five years, screening years 1-5 (SY1-SY5), were recorded for the mode of admission, occurrence of emergency surgery, 30-day mortality and Dukes staging.

Results: In the pre-screening year (1999), 29.4% of colorectal cancers were admitted as emergency, decreasing to 15.8% by 2004 (p=0.001). As a consequence, there was a significant decrease in the number of emergency colorectal cancer procedures performed over the same period (p<0.05). There is also a significant reduction in the 30-day mortality from 48% in 1999 to 13% in 2004(p<0.05). Dukes stage C carcinomas, however, remain the predominant stage presenting as emergencies throughout the studied period (SY3-53%, SY4-38%, SY5-50%).

Keywords: Admissions, Colorectal Cancer, Emergency, Faecal Occult Blood Testing, Screening

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