Increased compliance with an Enhanced Recovery After Surgery pathway is associated with improved clinical outcomes after resection for primary lung cancer. Several elements, including early mobilization, appear to be more influential than others.

No abstract

Background Evidence is emerging that the incidence of colorectal cancer is increasing in young adults, but the descriptive epidemiology required to better understand these trends is currently lacking. Methods A population‐based cohort study was carried out including all adults aged 20–49 years diagnosed with colorectal cancer in England between 1974 and 2015. Data were extracted from the National Cancer Registration and Analysis Service database using ICD‐9/10 codes for colorectal cancer. Temporal trends in age‐specific incidence rates according to sex, anatomical subsite, index of multiple deprivation quintile and geographical region were analysed using Joinpoint regression. Results A total of 56 134 new diagnoses of colorectal cancer were analysed. The most sustained increase in incidence rate was in the group aged 20–29 years, which was mainly driven by a rise in distal tumours. The magnitude of incident rate increases was similar in both sexes and across Index of Multiple Deprivation quintiles, although the most pronounced increases in incidence occurred in the southern regions of England. Conclusion Colorectal cancer should no longer be considered a disease of older people. Changes in incidence rates should be used to inform future screening policy, preventative strategies and research agendas, as well as increasing public understanding that younger people need to be aware of the symptoms of colorectal cancer.

N Context.-Synoptic pathology reports increase the completeness of reporting for colorectal cancer. Despite the perceived superiority of specialist reporting, service demands dictate that general pathologists report colorectal cancer specimens in many centers.Objective.-To determine differences in the completeness of rectal cancer reporting between specialist gastrointestinal and nongastrointestinal pathologists in both the narrative and synoptic formats.Design.-Pathology reports from rectal cancer resections performed between 1997 and 2008 were reviewed. A standardized, synoptic report was formally introduced in 2001. Reports were assessed for completeness according to 10 mandatory elements from the College of American Pathologists checklist.Results.-Overall, synoptic reports (n = 315) were more complete than narrative reports (n = 183) for TNM stage, distance to the circumferential radial margin, tumor grade, lymphovascular invasion, extramural venous invasion, perineural invasion, and regional deposits (all P , .01). Compared with those by nonspecialist pathologists, narrative reports by gastrointestinal pathologists were more complete for lymphovascular invasion (59.3% versus 35.9%, P = .02) and extramural venous invasion (70.4% versus 35.9%, P = .001), but there was no difference in completeness once a synoptic report was adopted. Gastrointestinal pathologists tended to report the presence of extramural venous invasion more frequently in both the narrative (18.5% versus 5.1%, P = .01) and synoptic formats (25.5% versus 14.6%, P = .02).Conclusions.-Completeness of reporting, irrespective of subspecialist interest, was dramatically increased by the use of a synoptic report. Improvements in completeness were most pronounced among nongastrointestinal pathologists, enabling them to attain a level of report completeness comparable to that of gastrointestinal pathologists. Further studies are required to determine whether there are actual discrepancies in the detection of prognostic features between specialist gastrointestinal and nongastrointestinal pathologists.