Cheshire & Merseyside Bowel Cancer Screening Programme April 2008

Programme first of its kind in Europe offered to both men & women (60-69, over 70 opt in) Clear evidence that FOB testing can reduce death rates by 16% Central budget of £12.5m 06/07 & £25m 07/08 National BCSP Profile

Organisation in England by March Programme Hubs across England, based on IT Local Service Providers (LSP) undertaking call/recall and lab functions Gateshead Nottingham London Guildford Rugby

Roll out plan Roll out plan

Cancer Reform Strategy Changes Extending screening from 2010 to year olds Extending screening from 2010 to year olds 62 day waits to apply – end day waits to apply – end 2008 Consideration of people in their 50s is next step Consideration of people in their 50s is next step – Flexi-sig trial results will be available in 2/3 years Immunological testing and CT colography to be considered in due course Immunological testing and CT colography to be considered in due course

Cheshire & Merseyside Programme Total population of 2.38 million Screening population of 330,000 Working across 8 Primary Care Trusts 18 PCT-based clinics 11 colonoscopy lists per week at RLH, Aintree and Leighton

Health Promotion Activity Media Media PHCT Education PHCT Education Community Education Community Education - Training and Health Events Health Inequalities Health Inequalities - Sensory Impairment - Black and Racial Minorities - Learning Disabilities and Patients with Mental Health Problems - Low Literacy

BCSP Clinical Statistics from September March 2008 Overall Uptake rate 55% Overall Uptake rate 55% 1268 patients seen in nurse led clinics following FOB positive result 1268 patients seen in nurse led clinics following FOB positive result 1215 colonoscopies performed 1215 colonoscopies performed 38 patients refused to have colonoscopy (2.6%) 38 patients refused to have colonoscopy (2.6%) 31 patients deemed clinically inappropriate (2.1%) 31 patients deemed clinically inappropriate (2.1%) 15 patients had completion barium enema (1%) 15 patients had completion barium enema (1%)

NEOPLASIA Total number of adenomatous polyps removed = 1330 (498 patients ) Total number of adenomatous polyps removed = 1330 (498 patients ) Total number of hyperplastic polyps removed =314 Total number of hyperplastic polyps removed =314 Total number of malignant polyps removed= 21 patients Total number of malignant polyps removed= 21 patients

Patient Outcomes 10% patients to have 1 year surveillance (High risk polyps) 10% patients to have 1 year surveillance (High risk polyps) 18% patients to have 3 year surveillance (Intermediate risk polyps) 18% patients to have 3 year surveillance (Intermediate risk polyps) 60% to return to screening programme with 2 yearly invitation to repeat participation in screening ( Low risk polyps) 60% to return to screening programme with 2 yearly invitation to repeat participation in screening ( Low risk polyps) 12% referred to local MDT for cancer treatment ( 141 patients ) 12% referred to local MDT for cancer treatment ( 141 patients )

Duke Staging of CRC on BCSP Duke A 53% (including malignant polyps) Duke A 53% (including malignant polyps) Duke B 21.4% Duke B 21.4% Duke C 21.4% Duke C 21.4% Duke D 4.2% Duke D 4.2% These figures are based upon 115 patients who had undergone surgery at time of audit and had definitive post-operative staging. These figures are based upon 115 patients who had undergone surgery at time of audit and had definitive post-operative staging.

Liverpool Screening Uptake Total screening population 52,408 Total screening population 52,408 January - March 07 =57.9% January - March 07 =57.9% April -June 07 =53.03% April -June 07 =53.03% June - Sep 07 =52.52% June - Sep 07 =52.52% Oct - Dec 07 =54.99% Oct - Dec 07 =54.99% Jan - March 08 =50.43% Jan - March 08 =50.43%

Liverpool Activity September 2006 _ March 2008 September 2006 _ March 2008 Total invitations sent 34,612 Total invitations sent 34,612 Self Referrals (over 70’s) 378 Self Referrals (over 70’s) 378 FOB Positive patients 441 FOB Positive patients 441 Nurse Clinic Attendance 350 Nurse Clinic Attendance 350 Colonoscopy Performed 353 Colonoscopy Performed 353 (including surveillance ) (including surveillance )

Liverpool Activity Adenomas removed from patients = 197 Adenomas removed from patients = 197 Cancers detected = 54 Cancers detected = 54

RLBUH DUKES CLASSIFICATION DUKES A = 52.17% DUKES A = 52.17% DUKES B = 8.69% DUKES B = 8.69% DUKES C = 34.8% DUKES C = 34.8% DUKES D = 4.34% DUKES D = 4.34% Total number of MDT referrals to date = 31 Total number of MDT referrals to date = 31

UHA DUKES CLASSIFICATION DUKES A = 53.3% DUKES A = 53.3% DUKES B = 20.0% DUKES B = 20.0% DUKES C = 26.7% DUKES C = 26.7% DUKES D = 0% DUKES D = 0% Total number of Liverpool MDT referrals to date = 23 (Sefton patients not included = 6) Total number of Liverpool MDT referrals to date = 23 (Sefton patients not included = 6)

WIRRAL DUKES CLASSIFICATION DUKES A = 33.3% DUKES A = 33.3% DUKES B = 33.3% DUKES B = 33.3% DUKES C = 26.8% DUKES C = 26.8% DUKES D = 6.6% DUKES D = 6.6% Total number of MDT referrals to date = 33 Total number of MDT referrals to date = 33

WESTERN CHESHIRES DUKES CLASSIFICATION DUKES A = 87.5% DUKES A = 87.5% DUKES B = 0% DUKES B = 0% DUKES C = 12.5% DUKES C = 12.5% DUKES D = 0% DUKES D = 0% Total number of MDT referrals to date = 18 Total number of MDT referrals to date = 18

CENTRAL AND EASTERN CHESHIRE DUKES CLASSIFICATION DUKES A = 53.8% DUKES A = 53.8% DUKES B = 46.2% DUKES B = 46.2% DUKES C = 0% DUKES C = 0% DUKES D = 0% DUKES D = 0% Total number of MDT referrals to date = 23 Total number of MDT referrals to date = 23

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