Deaths after operations for bowel cancer in NHS hospitals range from one in 50 to almost one in six, according to the first comparison of cancer surgery survival rates.
NHS patients have the right to choose where to go for surgery. The landmark study reveals for the first time where to go for your cancer op – and where to avoid. Patients face a seven-fold higher risk of dying after surgery in some NHS trusts than others, the study shows.
Britain also performs poorly compared with other Western countries such as Scandanavia, Canada and the US, with a death rate up to twice as high, according to the study of 160,000 patients over nine years.
In the UK, Burton Hospitals NHS Foundation trust in Derbyshire had the highest death rate, at 15.7 per cent, or one death in every 6.3 operations. Central Manchester University Hospitals NHS Foundation trust had the lowest death rate at 2 per cent – one death in 50 operations. The variation was described as "worrying" by Cancer Research UK, which funded the study published in the journal Gut. But experts said it was too soon to explain what lay behind it, which now needed investigation.
Professor Sir Mike Richards, the Government's cancer tsar, said: "This study is a landmark for cancer. Good information is needed by patients, by commissioners and by clinical teams and feeding back information to clinical teams will I believe improve outcomes."
Heart surgeons began publishing their figures 13 years ago and death rates after heart surgery have fallen 50 per cent in the past decade. Professor Richards said training programmes in new methods of bowel surgery were being introduced and bowel screening was being expanded. "I predict this is a cancer where we will see more improvement than any other over the next five years," he said.
Bowel cancer is the third most common cancer (after lung and breast) with 35,000 cases and 16,000 deaths a year. Surgery to remove the tumour is the mainstay of treatment and overall death rates within 30 days of surgery stood at 6.7 per cent over the nine-year period from 1998 to 2006.
This compared with death rates ranging from 2.7 per cent (for rectal cancers alone) to 5.7 per cent in countries such as Canada, the US and Scandanavia. The authors of the study, from the University of Leeds and the London School of Hygiene and Tropical Medicine, say: "This suggests that either the NHS may have fundamentally worse postoperative outcomes than some other comparable health services or the operative risk of patients differs between countries. Understanding and minimising these differences could significantly reduce the number of premature deaths caused by this disease across the country."