RESEARCH has shown treatment of oesophageal cancer in England demonstrates SIGNIFICANT regional variations.
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| A report has revealed huge regional variations in treatment for oesophageal cancer |
The study also discovered treatment for Barrett's oesophagus is subject to a postcode lottery.
According to the cancer support charity Macmillan, Barrett's oesophagus is a condition where the cells of the oesophagus grow abnormally - in a small number of people this may gradually develop in to cancer.
The findings were uncovered by the Oesophageal Cancer Westminster Campaign (OCWC) report.
It outlined the huge geographical variations between people receiving treatment for Barrett's oesophagus and early cancer.
Using data obtained by the Freedom of Information Act, the report found almost 50 per cent of Londoners receive this treatment compared to a measly six per cent in the East Midlands and a shocking 3.2 per cent in the West Midlands.
The main findings of the report included the fact many trusts are unable to provided detailed data on Barrett’s oesophagus and oesophageal cancer that may indicate inadequacies of the recording and handling of data.
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| 50 per cent of Londoners receive this treatment, compared to 3.2 per cent of West Midlanders |
More worryingly, few Trusts were even able to provide evidence of recording AND tracking patients whose Barrett’s oesophagus developed in to oesophageal cancer.
It also revealed only a minority of patients with Barrett’s oesophagus receive a formal diagnosis.
On top of this, there is significant geographical variation in the application of endoscopic therapies for Barrett's oesophagus and early cancer.
On the other hand, the report did reveal the proportion of patients treated with endoscopic therapies for Barrett's oesophagus has increased over the last three years, from 18 per cent to almost a third.
It has been estimated that around 950 lives could be saved in this country each year if our survival rates matched the best in Europe.
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| The report outlined recommendations for change |
In order to improve this outcome, the OCWC has recommended the following changes:
- Access to endoscopic therapies for Barrett's oesophagus and oesophageal cancer should be improved across the country to prevent the current "postcode lottery" of provision.
- Endoscopic Mucosal Resection and Radio Frequency Ablation should be restricted to resectional cancer centres to ensure quality and allow the appropriate discussion of all treatment options.
- Greater professional awareness of treatment options.
- A simple best practice pathway should be developed by Clinical Commissioning Groups for Trusts to follow.
- NICE guidelines around early intervention and treatment should be strengthened and structures should be put in place to ensure these are followed.
- There should be enhanced emphasis on, and training for, the diagnosis and treatment of Barrett's oesophagus with the aid of improved diagnosis tools and options.
- Trusts should be encouraged to record not only total numbers of those with oesophageal conditions, but also the type and stage.
- There should be better monitoring and recording, and visible annual reporting of all cases and stages of Barrett's, oesophageal cancer and the number of patients progressing from the former to the latter.
- There should be a reassessment of current reimbursement systems and an analysis of whether this creates a barrier to the adoption of some vital treatments.
- All diagnosed cases of Barrett's oesophagus should be registered with the UK National Barrett's Oesophagus Registry to ensure surveillance is managed by one specialist entity across the country.
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| Only a minority of patients with Barrett’s oesophagus receive a formal diagnosis, says the report |
Chair of the OCWC Tim Underwood said: "The UK has the highest rate of oesophageal cancer patients in the world, with this terrible disease killing 7,000 people every year.
“So much more needs to be done to make sure we improve the way we diagnose and treat this cancer and I believe that the recommendations we've made can make a big step towards saving hundreds of lives.
“In particular the postcode lottery of treatment needs to ended, with specialist treatment available across the country.
“The OCWC represents patients and families who have been affected by this disease, campaigning for raise awareness of oesophageal cancer, to support earlier diagnosis and improved patient access to treatment.
“We hope that this report can shine a light on this disease and help bring about improvements in care."
Barrett's oesophagus sufferer Colette Skilling said: "Having received treatment for Barrett's oesophagus I am worried by the findings of the report. With a significant chance of becoming cancer every patient needs to be diagnosed early and treated in the best way possible.
"I referred myself for the treatment I needed and I am worried that people in other areas of the country may not simply because of their postcode or the knowledge that the treatment is availed.
“We need to make sure that all patients diagnosed with Barrett's or oesophageal cancer have the option of endoscopic treatment rather than surgery and are under proper surveillance."
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