Management of colorectal cancer patients in Australia: the National Colorectal Cancer Care Survey

Abstract

With the considerable resources required to develop clinical practice guidelines, studies like this are essential to monitor the impact of the guidelines. To ensure that the guidelines are in line with current evidence, regular reviews of the guideline recommendations are required.

Tumor Pathology and Long-Term Survival in Emergency Colorectal Cancer

“…1 Nationally, Australia has an emergency CRC rate of 10.7 percent. 10 Patients in this study lived in the southwestern part of Sydney with a high proportion of recent migrants. From 1997 to 2004, the rate for emergency operation has averaged 15.8 percent and shows no sign of decreasing (range, 12.6-17.7 percent; trend test P=0.96).…”

Potential hospital cost-savings attributed to improvements in outcomes for colorectal cancer surgery following self-audit

“…The primary goal of all studies was to document the surgical management and patient outcomes in their populations. Two reports documented outcomes for the same study [10,11]. In summary, the range of published adverse events used to populate our model were 0.5-2.8% for anastomotic leaks, 2.1-9.1% for wound infections, 0.3-6.7% for DVT, 2.7-12.2% for return to theatre, 0.2-10.7% for respiratory conditions and 0.2-7.7% for 30-day deaths.…”

“…This rate was considered an outlier and omitted from our summary estimates. Five studies, including three in NZ [12-14], reported outcomes from regional areas [4,12-15] while the remainder were state-wide [16], national [10,11,17] or urban-based [18,19]. One study accounted for pre-operative factors and outcomes were risk-adjusted [4].…”

“…No study reported estimates on multiple complications occurring concurrently during the hospital stay and only two studies reported mortality rates directly arising from the complications [11,19]. Post-operative outcomes tended to be poorer for emergency presentations and for rectal surgery, the latter which involves more complex and difficult surgery [10,15]. In the National Colorectal Cancer Survey, no statistically significant differences were found for post-operative morbidity and mortality for high- and low-volume surgeons (defined as ≥7 or <7 surgeries per quarter, respectively) although some pre-operative practice differences were evident [11].…”

Perceived impact on clinical practice and logistical issues in clinical management surveys of cancer: Australian experience

“…In Australia, many CMS of cancer patients have been undertaken, and many have been large, with high response rates, and based on patients drawn from population-based cancer registries. There have been national CMS for breast1 2 and colorectal cancer3 4 and surveys at a state or territory level for many other cancer sites. A descriptive review of all published CMS up to 2003 forms the base for this study 5.…”