Northern Region Colorectal Cancer Audit (NORCCAG) Colorectal NSSG – Audit meeting 1 st April 2006 – 31 st July 2010 Dorothy Simms – Audit Co-ordinator.

Northern Region Colorectal Cancer Audit

(NORCCAG)Colorectal NSSG – Audit meeting

1st April 2006 – 31st July 2010

Dorothy Simms – Audit Co-ordinatorFriday 6th May, 2010

• 3.1 million

• approx 1700 cases/annum

• Prospective Audit

• 1997 – Ongoing

• ‘Population’ based

Process• Extracted from NBOCAP (8012 records)

• Removed duplicate treatments (7020 records)

• Supplemented by Research Fellows and clinicians

• Validation

• Analysis

Appendix 0.30%

Caecum 14.40%

Ascending 9.10%

Hepatic 3.16%

Transverse 5.43%

Splenic 2.48%

Descending 3.29%

Sigmoid 22.76%

Rectosigmoid 8.42%

Rectum 30.66%

Appendix 21Caecum 1011Ascending 639Hepatic 222Transverse 381Splenic 174Descending 231Sigmoid 1598Rectosigmoid 591Rectum 2152

Site of Tumour n=7020

Demographics n=7020

0

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15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 >100

Age Group

Fre

qu

en

cy

Age: Median = 71 (17 -102) Sex: Male 3991 (56.85%) Female 3029 (43.15%)

Denominator n=7020

No Procedure n=1571 (22.4%)**no evidence of surgical procedures although a small number had a pathology recorded

Procedures n=5449**5130 (73.0% of 7020) had a resective procedure

4655 (85.4%) are known to have a resection

160 (2.9%) underwent local excisions

131 (2.4%) patients only had stomas formed

161(3.0%) had their tumours stented

315 (5.8%) recorded as having other procedures

Operative Procedures (n=5449)

Resections Local ExcisionsRight Hemi 1302 (23.9%) TEMS 31 (0.6%)Ext Rt Hemi 382 (7.0%) Per Anal Excision 14 (0.3%)Transverse Col 18 (0.3%) Polypectomy 115 (2.1%)Left Hemi 470 (8.6%)Sigmoid Col 283 (5.2%) Other proceduresAnt Res 1444 (26.5%) Palliative 319 (5.9%)Total Col 100 (1.9%) Other 315 (5.8%)Hartmanns 220 (4.0%)APER 353 (6.5%)Panproctocolectomy 83 (1.5%)

Rectal cancers n=2152

No procedure recorded: n=584 (27.1%) => Denominator = 1568

Resections: n=1252 (79.8%)

APER 342 (21.8%) Lt Hemicolectomy 4 (0.3%)

Ant Res 784 (50.0%) Sigmoid colectomy 4 (0.3%)

Hartmanns 95 (6.1%) Total colectomy 8 (0.6%)

Panproctocolectomy 15 (1.0%)

Local Excisions: n=84 (5.4%)

TEMS 30 (2.0%)

Per anal excision 13 (0.8%)

Polypectomy 41 (2.6%)

Other Procedures: n=232 (14.8%)

83 stomas, 25 stents, 2 Dx Invxs, 1 EUA, 7 open and close, 114 other

Grade of Operating Surgeon by Cancer Unit

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Cancer Unit

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Registrar

Consultant

ASA classification by Cancer Unit

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Open

Surgical Access – 1st April 2006 to 31st July 2007

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Surgical Access – 1st August 2007 to 31st July 2008

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Surgical Access – 1st August 2008 to 31st July 2009

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Surgical Access – 1st August 2009 to 31st July 2010

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Scheduled

Emergency/Urgent

Elective

Urgency of Operation by Cancer Unit

Dukes Stage by Cancer Unit

1153 patients were recorded as having stage ‘D’ disease

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Stage ‘D’ disease by Cancer Unit

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Cancer Unit

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2006/7

2007/8

2008/9

2009/10

Lymph Node Yield

Role of NORCCAG

Publication and dissemination of results

Regional presentations 6th May 2011

Written Report 27th May 2011

Local presentations June – October 2011

Corrected/validated data regional presentation TSSG

The future of NORCCAG

To be discussed………..