colorectal cancer pathways Laura Hope Programme Manager - - PowerPoint PPT Presentation

Risk Stratified Follow up in colorectal cancer pathways

Laura Hope Programme Manager

Collaborating to improve cancer care

Introduction

Collaborating to improve cancer care

Background

Background

• Achieving World Class Cancer Outcomes - A Strategy for England

2015-20

• 96 recommendations- Living with and beyond cancer

– by 2020 every person with cancer will have be risk stratified to the most appropriate pathway of follow-up care.

• Clinically agreed protocols for stratified follow up which are

implemented and commissioned by 2020

• Clinical Advice to Cancer Alliances for the Commissioning of the

Whole Bowel Cancer Pathway (November 2017)

Collaborating to improve cancer care

Guidance

• Clinical Advice to Cancer Alliances for the Commissioning of the

Whole Bowel Cancer Pathway November 2017

• Inclusion / exclusion criteria
• A minimum follow-up schedule

– Surveillance and CEA tests – liver and colonoscopy

• Treatment summary
• Re-entry pathway

– Two week response rate to any patients with concerns and possible discussion at MDT.

Stratified Follow up Pathways

Collaborating to improve cancer care

Stratified Follow up Pathways

Collaborating to improve cancer care

Inclusion / Exclusion Criteria

Collaborating to improve cancer care

• Low risk tumours (T1-3a N0) treated with surgery alone
• Good support and minimal late effects
• Moderate risk rectal cancer (T3b-4 or N1-2 or with extra

mural lymphovacular invasion)

• Patients with stomas, bowel function, and other late

effects of treatment

• Patients who have not had adjuvant treatment will be

followed up by the surgeons

• Patient who wish to be followed up

Activity

Collaborating to improve cancer care

• Regional population of 3.2 million
• 2,065 first treatments for colorectal cancers in 2017/18

(source Cancer Waiting Times activity reports).

• 100% stratification against protocol
• Low risk - 826 patients based on 40% of all colorectal first

treatments being eligible

• Per Trust who offer colorectal it is between 60 and 110 patient

and for tertiary centres 150-175

Next Steps

Collaborating to improve cancer care

• Protocol
• Share clinical guidelines
• Follow up in primary care
• Service specification