north east bowel screening cancer study doctorate of medicine, university of durham

North East Bowel Screening Cancer Study

Doctorate of Medicine, University of Durham

• Large scale epidemiological study of all colorectal cancers– In population eligible for screening as part of

the National Bowel Cancer Screening Programme

– Within the Northern Region

• Approximately 1500 patients included– Aged 60-69 at time of diagnosis– Between April 2007- April 2010

• Combination of data from: – NORCCAG Database– Regional Bowel Cancer Screening Database

Cases of Colorectal

Cancer

Screen Detected Cancer

Interval CancerNon-Uptake

Cancer

Non-Uptake of FOBt

Non-Uptake of Colonoscopy after Positive

FOBt

Cancer after Negative FOBt

Cancer after Negative

Colonoscopy

Cancer before Planned

Surveillance Colonoscopy

• Comparing the three patient groups described above, are there any differences in the epidemiology of the patients? Examples of data analysed will be:– Socioeconomic group and level of deprivation– Co-morbidities

• What is the rate of interval cancer within the screening programme?– What type of interval cancer?

– What are the reasons behind it?

– How many positive FOB windows to these patients have – should we be performing more colonoscopies on those with weakly positive tests?

– What groups of patients have an interval cancer?

• Details of the cancers within each patient group– Are there any differences between the stages of

cancers found in each group?– Is there a shift towards earlier cancers within

the screen detected group and is there any difference in the interval group?

Errors & Missing Data Review

Michael Gill

NORCCAG Research Fellow

• Sample of data from NBOCAP extract– Analysed for

• Missing data

• Data accuracy

• Database analysed by NORCCAG research fellows

• Error and missing data queries created using Microsoft Access

• Results summarised using SPSS

ASA Grade

Stomas

• Of 1409 stomas recorded - total of 271 (19.2%) errors in recording of type of stoma– Includes those errors in the palliative procedure

category

Urgency of Procedure

Surgical Access

Grade of Operating Surgeon

Tumour Location vs. Operation

• Of 5449 recorded procedures – Total of 271 (5.0%) errors– Including those errors within palliative

procedures

Conclusion

• Significant errors seen throughout the database– Some human error– Some inbuilt errors within NBOCAP

• NORCCAG is able to identify these errors and missing data with ease, in order to aid correction

Any Questions?