11 July 2019

National Bowel Cancer Audit Short Report – End of Life

National Bowel Cancer Audit Short Report – End of Life
HQIP 11 July 2019
  • Patients are defined as approaching the ‘end of life’ when they are identified as being likely to die within 12 months. Concerns have been raised about the variation in the quality of end of life care received by patients, with several reports highlighting poor care. This short report aimed to look at patients diagnosed with colorectal cancer who were at the ‘end of life’.
  • As expected, patients who did not live for more than a year from diagnosis tended to be older, have metastases, have poorer performance status, and to undergo no surgical procedure. 
  • However, what was not known was that these patients had, on average, two hospital admissions with a length of stay of 18 days each and that a third spent over a month of their last year in hospital. 
  • 86% of those who lived for less than one year had at least one emergency hospital admission and, if  that admission was in their last month, nearly two thirds died in hospital.
  • Of concern, patients with higher levels of deprivation appear to be more likely to die within 12 months of diagnosis, despite adjustment for other factors. This suggests that there may be some inequalities in access to colorectal cancer care services.