Despite the lack of high-level evidence,ESRF and renal transplantation were associated with colorectal complications that could result in major morbidity and mortality. Bowel cancer screening in this patient group appears justified. The effectiveness of screening for HPV, AIN and anal cancer in renal transplant recipients remains unclear.
Aims The COVID-19 pandemic has resulted in an unprecedented challenge. With the abolition of all non-urgent endoscopies nationwide, there has been concerning implications on colorectal cancer (CRC) diagnosis. Rationing of these scarce colonoscopy slots has become a priority. Faecal immunohistochemistry test (FIT) results are predictive of bowel pathology. Here we audit the clinical outcomes of patients that have undergone FIT in our health board in the pre and COVID-19 era. Methods Using business intelligence methods, an automated system for NHS eHealth data collection has been established. All patients who have undergone FIT testing are audited for clinical outcomes including investigation and pathology. Results from December 2018-2019 (pre-COVID) were compared to December 2019-January 2021 (COVID). Results There was a 70.12% increase in FIT uptake. 58.88% were female. Median age 73 (range 1-100). FIT results are compared below. Conclusion Our business intelligence approach has improved uptake of FIT in our community. There have been proportionally higher rates of colorectal cancer diagnosis with less resources. FIT specificity is 98.64% and therefore should be further widely accepted to ration resources.
Treatment for patients with locally advanced low lying rectal cancer differs significantly from patients with rectal cancer restricted to the mesorectum. Surgical resection will be the straightforward option for the early ones but multimodality treatment, including preoperative chemo-radiation and extended surgical resection will be the options for advanced ones. Cylindrical abdominoperineal excision of rectum (C-APER) along with possible composite pelvic organ resection is a surgical method to remove an adequate circumferential margin so to reduce the local recurrence rate and improve long term survival. Adequate preoperative imaging of the pelvis is therefore important to identify these patients and effort should be made to select those patients with advanced tumours with no systemic spread. In this article, we reviewed some consecutive cases of advanced rectal cancer to their immediate surgical outcome.
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