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

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North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

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Page 1: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

North East Bowel Screening Cancer Study

Doctorate of Medicine, University of Durham

Page 2: 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

Page 3: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

• 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

Page 4: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

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

Page 5: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

• 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

Page 6: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

• 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?

Page 7: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

• 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?

Page 8: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

Errors & Missing Data Review

Michael Gill

NORCCAG Research Fellow

Page 9: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

• Sample of data from NBOCAP extract– Analysed for

• Missing data

• Data accuracy

Page 10: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

• Database analysed by NORCCAG research fellows

• Error and missing data queries created using Microsoft Access

• Results summarised using SPSS

Page 11: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham
Page 12: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

ASA Grade

Page 13: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham
Page 14: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

Stomas

Page 15: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham
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Page 17: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham
Page 18: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

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

category

Page 19: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

Urgency of Procedure

Page 20: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham
Page 21: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

Surgical Access

Page 22: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham
Page 23: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

Grade of Operating Surgeon

Page 24: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham
Page 25: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

Tumour Location vs. Operation

Page 26: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham
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Page 28: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

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

procedures

Page 29: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

Conclusion

Page 30: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

• 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

Page 31: North East Bowel Screening Cancer Study Doctorate of Medicine, University of Durham

Any Questions?