Introduction The management of gastro-intestinal (GI) malignancy is largely determined by multi-disciplinary team (MDT) discussion, where members have not met the patient. The quality of information given to the patient immediately following endoscopy, and subsequently to the MDT, is variable.
Methods A 3 month retrospective audit of all outpatient endoscopic diagnoses of upper and lower GI malignancies at Derriford Hospital, Plymouth. The endoscopy report (Endosoft), endoscopy care pathway and medical notes were reviewed. Information provided regarding the description of pathology; post endoscopic patient discussion; GI Cancer Nurse Specialist (CNS) involvement and request for staging imaging was interrogated. Inpatients were excluded.
Results There were 65 patients with GI malignancy (oesophago-gastric cancer [OGC] n = 24; colorectal cancer [CRC] n = 41). For patients with confirmed OGC the report recorded suspected malignancy in 19/24 (79%). Post endoscopy patient discussion was recorded on the report in 7/19 (37%); patient informed & recorded only in the nurse’s care pathway in 5/19 (26%); no evidence of discussion with patient in 7/19 (37%). GI CNS involvement was documented on the report in 5/19 (26%); the report documented requesting of staging imaging by the endoscopist in 10/19 (53%). For patients with confirmed CRC the report recorded suspected malignancy in 33/41 (80%). Post endoscopy discussion was recorded on the report in 10/33 (30%); patient informed & recorded only in the nurse’s care pathway in 13/33 (39%); no evidence of discussion with patient in 10/33 (30%). GI CNS involvement was documented in 15/33 (45%). The report documented requesting of staging imaging by the endoscopist in 22/33 (67%).
Conclusion The MDT relies upon patients being informed of their suspected diagnosis, and accurate endoscopic documentation in order to make informed decisions and to allow direct referral to Surgical and Oncological specialities. However, a significant proportion of patients with upper and lower GI cancer leave the endoscopy department without a diagnosis of suspected cancer being made, and even when it is suspected, are frequently not informed by the endoscopist.
Disclosure of Interest None Declared.
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