Adherence to NICE Guidelines on Colorectal Cancer Follow-Up: A Cross-Sectional Analysis

Purpose: Our aims were to determine adherence to National Institute of Clinical Excellence (NICE) guidelines on colorectal cancer (CRC) surveillance and to evaluate local practice patterns determine how it can be further improved. Patients and methods: Patients with colorectal cancer resection between January 1, 2017 and December 31, 2017 were identified, and their records retrospectively reviewed. Results: A total of 18 patients were eligible. Surveillance patterns, including blood tests and colonoscopies, were inconsistent with NICE recommendations in a significant proportion of patients. Follow up appointments and CT imaging occurred more frequently in line with the guidelines. For recurrences detected by surveillance, 66.6% were resectable whereas 0% of those detected by symptoms were resectable. Conclusions: The results prove that a moderately intensive follow-up strategy can positively identify resectable recurrence thus increasing overall survival. Our data highlights the need for local improvement to adherence to NICE guidelines regarding CRC follow-up. We have created a pro forma which is attached to the patient's clinical notes. It will aid clinicians in reminding them when appropriates tests should be completed. A re-audit will be completed in December 2020 which will include looking at the effectiveness of the new pro forma.