Bowel cancer progress in Morecambe Bay: Laparoscopic bowel surgery and the anaesthetists view

Abstract

Adenocarcinoma of the colon and rectum is the third most common cancer in the UK and the second commonest cause of cancer death, after breast cancer in women and lung cancer in men. Almost 30,000 new cases were registered in England and Wales in 2002, representing 12% of all new cancer cases and some 16,000 patients died of it. The incidence increases with age. Between 45 and 49 years, the incidence is 20 per 100,000 per year, rising to 300 for men and 200 for women in those aged 75 and older. Approximately 300 new cancers are being diagnosed every year in the Morecambe Bay area. The so-called ‘adenoma-carcinoma sequence’ accepts that benign adenoma polyps are the precursors of colon cancer in 95% of cases. Such observations, together with the slow growth of bowel cancers and the opportunity for them to be recognised at colonoscopy 2-3 years before the onset of symptoms provides the rationale for the systematic screening and endoscopy of high risk cases. Surgery is required for 220 cases in the Morecambe Bay area each year and new techniques in surgery and anaesthesia have revolutionised bowel cancer management. Articles by Susan Meyrick (Nurse Lead at the Cumbria and Morecambe Bay Bowel Cancer Screening Centre), Christine Bronder (consultant surgeon) and Chris Coldwell (consultant anaesthetist) report for the Journal on recent advances in the management of this difficult disease.