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. 2012 Aug 21;107(5):757-64.
doi: 10.1038/bjc.2012.331. Epub 2012 Jul 31.

A retrospective observational study examining the characteristics and outcomes of tumours diagnosed within and without of the English NHS Bowel Cancer Screening Programme

E J A Morris  1 , L E Whitehouse, T Farrell, C Nickerson, J D Thomas, P Quirke, M D Rutter, C Rees, P J Finan, J R Wilkinson, J Patnick
Affiliations

A retrospective observational study examining the characteristics and outcomes of tumours diagnosed within and without of the English NHS Bowel Cancer Screening Programme

E J A Morris et al. Br J Cancer. .

Abstract

Background: Colorectal cancer is common in England and, with long-term survival relatively poor, improving outcomes is a priority. A major initiative to reduce mortality from the disease has been the introduction of the National Health Service (NHS) Bowel Cancer Screening Programme (BCSP). Combining data from the BCSP with that in the National Cancer Data Repository (NCDR) allows all tumours diagnosed in England to be categorised according to their involvement with the BCSP. This study sought to quantify the characteristics of the tumours diagnosed within and outside the BCSP and investigate its impact on outcomes.

Methods: Linkage of the NCDR and BCSP data allowed all tumours diagnosed between July 2006 and December 2008 to be categorised into four groups; screen-detected tumours, screening-interval tumours, tumours diagnosed in non-participating invitees and tumours diagnosed in those never invited to participate. The characteristics, management and outcome of tumours in each category were compared.

Results: In all, 76 943 individuals were diagnosed with their first primary colorectal cancer during the study period. Of these 2213 (2.9%) were screen-detected, 623 (0.8%) were screening-interval cancers, 1760 (2.3%) were diagnosed in individuals in non-participating invitees and 72 437 (94.1%) were diagnosed in individuals not invited to participate in the programme due to its ongoing roll-out over the time period studied. Screen-detected tumours were identified at earlier Dukes' stages, were more likely to be managed with curative intent and had significantly better outcomes than tumours in other categories.

Conclusion: Screen-detected cancers had a significantly better prognosis than other tumours and this would suggest that the BCSP should reduce mortality from colorectal cancer in England.

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Conflict of interest statement

Julietta Patnick is the Director of the NHS Bowel Cancer Screening Programme. Claire Nickerson, Matt Rutter, Colin Rees and Phil Quirke are all employed (either full time or on a sessional basis) by the NHS Bowel Cancer Screening Programme. Tom Farrell was employed on a University of Leeds Research Grant provided by the NHS Bowel Cancer Screening Programme.

Figures

Figure 1
Figure 1
Distribution of tumours by their location in the bowel across the tumour categories.
Figure 2
Figure 2
Distribution of tumours by stage at diagnosis across the tumour categories (staged cases only).
Figure 3
Figure 3
The distribution of primary procedures used to treat the tumours in each category.
Figure 4
Figure 4
One-year survival by tumour category.
See this image and copyright information in PMC

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