Introduction The Bowel Screening Wales (BSW) Network Multi Disciplinary Team (NMDT) and National Referral Centre (NRC) pilot was established in October 2011 to offer the opportunity for expert opinion and discussion of therapeutic options for participants with complex benign polyps detected on the Welsh bowel screening programme.
Methods Participants with lesions that satisfied the agreed criteria were referred to the NMDT for advice from the expert panel regarding management. Recommended outcomes included local endoscopic or surgical treatment or referral to the NRC for endoscopic or surgical treatment.
Between the 17th of October 2011 and the 20th August 2012 October 2012 100 cases from all over Wales were discussed at NMDT meetings by video conference. Referrals were received from all 6 Health Boards in Wales and 11 of the 14 Local Assessment Centres (LAC) during this time frame.
Referral data and NMDT decisions were prospectively stored on a shared drive and a comprehensive data set entered onto the BSW registry for complex polyps.
Results The first 100 cases discussed at NMDT meetings satisfied the following referral criteria:
21 lesions with difficult to access
17 lateral spreading tumours > 2cms
11 participants with polyps greater than 4cms
20 participants with polyps in the right colon > 2cms
7 participants with residual polyps
52 cases were referred back to Local Assessment Centres for treatment, and 48 to the NRC for treatment. Detailed data on procedure type and final outcome will be presented in June.
All cases referred to the NMDT for discussion were thought to be benign at the time of referral which was confirmed by initial biopsy. Final histology was found to be adenocarcinoma in 6 cases. Data analysis will continue and include recurrence rates at 3, 6 and 12 months, post procedure complication rates and final number of procedures undertaken per participant for each lesion removed.
Conclusion The BSW NMDT and NRC have facilitated equity of service for participants of the bowel screening programme in Wales with complex benign polyps. Referrals to surgery for benign disease have been reduced as a result. This process has also facilitated central referral for specialist endotherapy and surgical procedures.
Disclosure of Interest None Declared.
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