1. Cheshire & Merseyside Bowel Cancer Screening Programme April 2008

2. Cancer Reform Strategy Changes Extending screening from 2010 to 70-74 year olds Extending screening from 2010 to 70-74 year olds 62 day waits to apply – end 2008 62 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

3. 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

4. Cheshire and Merseyside BCSP Clinical Statistics from September 2006- 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%)

5. 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

6. 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 )

7. 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.

8. Central and Eastern Cheshire PCT Screening Uptake Total screening population 65,134 Total screening population 65,134 April -June 07 =40.0% April -June 07 =40.0% July - Sep 07 =56.00% July - Sep 07 =56.00% Oct - Dec 07 =59.00% Oct - Dec 07 =59.00% Jan - March 08 =60.00% Jan - March 08 =60.00%

9. Central and Eastern Cheshire PCT Activity April 2007 _ March 2008 April 2007 _ March 2008 Total invitations sent 29,872 Total invitations sent 29,872 Self Referrals (over 70’s) 736 Self Referrals (over 70’s) 736 FOB Positive patients 290 FOB Positive patients 290 Nurse Clinic Attendance 216 Nurse Clinic Attendance 216 Colonoscopy Performed 213 Colonoscopy Performed 213 (including surveillance ) (including surveillance )

10. Central and Eastern Cheshire PCT Adenomas removed from patients = 99 Adenomas removed from patients = 99 Cancers detected = 27 Cancers detected = 27

11. CENTRAL AND EASTERN CHESHIRE PCT 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

12. WESTERN CHESHIRE PCT SCREENING UPTAKE Total screening population 35,470 Total screening population 35,470 July - Sep 07 =49.00% July - Sep 07 =49.00% Oct - Dec 07 =56.00% Oct - Dec 07 =56.00% Jan - March 08 =59.00% Jan - March 08 =59.00%

13. Western Cheshire PCT July 2007 _ March 2008 July 2007 _ March 2008 Total invitations sent 14,825 Total invitations sent 14,825 Self Referrals (over 70’s) 431 Self Referrals (over 70’s) 431 FOB Positive patients 145 FOB Positive patients 145 Nurse Clinic Attendance 95 Nurse Clinic Attendance 95 Colonoscopy Performed 87 Colonoscopy Performed 87 (including surveillance ) (including surveillance )

14. Western Cheshire PCT Activity Adenomas removed from patients = 34 Adenomas removed from patients = 34 Cancers detected = 12 Cancers detected = 12

15. 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

16. 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

17. 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)

18. Further Information www.cancerscreening.nhs.uk www.cancerscreening.nhs.uk www.cancerscreening.nhs.uk www.bcsp.nhs.uk www.bcsp.nhs.uk www.bcsp.nhs.uk www.endoscopy.nhs.uk www.endoscopy.nhs.uk www.endoscopy.nhs.uk www.grs.nhs.uk www.grs.nhs.uk www.grs.nhs.uk www.thejag.org.uk www.thejag.org.uk www.thejag.org.uk www.doh.gov.uk www.doh.gov.uk www.doh.gov.uk