Annual Report

This year's annual report was published in July 2012 (https://catalogue.ic.nhs.uk/publications/clinical/oesophago-gastric/nati-clin-audi-supp-prog-oeso-gast-canc-2012/clin-audi-supp-prog-oeso-gast-2012-rep.pdf) and focused on the results of the organisational survey, and provided longer-term follow up and analysis of data collected during the first audit cycle.

The key findings were:

• Reorganisation of cancer services has been completed and patients have good access to key diagnostic services and therapeutic procedures.
• There was substantial variation in route to diagnosis, with overall 16.4% of patients were being diagnosed after an emergency admission. This group has a lower chance of proceeding to curative treatment, so early diagnosis and detection is still a key issue.
• 3 year survival rates after curative therapy have improved, with rates of 41% for oesophageal squamous cancers, 46% for oesophageal adenocarcinomas and 49% for gastric cancers. This is compared to 34% for oesophageal cancer, and 40% for gastric cancer treated in the 1990’s with curative intent.

Initial results from 2nd Audit

This focuses on patients diagnosed between 1st April 2011 and 31st March 2012. Initial results appear encouraging, with preliminary analysis suggesting:

• Overall case ascertainment of 80% (10% higher than previous audit).
• Clinical information was collected from 10,604 patients.
• 3291 patients treated with curative intent.
• In-hospital mortality rates are continuing to fall.

Full analysis of these results will be published in June 2013 in the second Annual Report. Data will be provided at NHS trust level to allow national benchmarking and identify areas for potential improvement.

What is new?

New Dataset: For patients diagnosed since April 2012 the dataset has been revised, with the aim of being more focused and also allowing collection of data on patients with HGD. The new dataset has decreased the number of data items required, but more key variables are now mandatory. These changes follow requests from the last audit and we hope therefore will provide NHS trusts with more useful information.

To submit this data NHS trusts will need to re-register for the new data collection system, to comply with information governance requirements. Note that updating the dataset will mean CSV files will need to be adjusted as both the structure and data item have changed.

High Grade Dysplasia (HGD): From 1st April 2012, data on patients diagnosed with HGD of the oesophagus is being collected. Little is known about the care of this patient group. It is estimated that there are 1350 new cases per year in England and Wales and it is recommended that all these patients are discussed in the specialist MDT. The new dataset aims to evaluate the management of patients, their treatment and early outcomes.

Online reporting system: This is currently being revised with aim of providing clinicians with up to date clinically relevant information. Units will be able to download their data from the Audit’s IT system into Excel sheets. This will allow it to be used for local quality improvement and to support peer review.

The Future

Overall, the case ascertainment and quality of data continues to improve and this would not be possible without the huge amount of work everyone is putting in, from clinicians, to data managers and MDT co-ordinators across the country.

Finally, we would like to make a special plea to for you to engage with your pathology and surgical colleagues to ensure you have robust systems to facilitate MDT review of all patients with HGD. As incidence of HGD is relatively low, high case ascertainment is crucial to make the results valid for this patient group.

The Audit will continue to be led clinically by Richard Hardwick, Stuart Riley and Tom Crosby. Methodological aspects are supervised by David Cromwell and Oliver Groene at the RCS Clinical Effectiveness Unit (CEU). We have now recruited a new Clinical Fellow Georgina Chadwick (a Gastroenterology SpR), who will be working on the project based at the CEU. Kimberly Greenaway continues as the Project Manager.

If you have any further questions, do get in contact with one of us and thank you again for all your hard work.

Kind regards,

Stuart Riley

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The National Oesophago-gastric Cancer Audit is pleased to announce that the new audit data collection system is now live.

The new data collection system is aligned to the new dataset for patients diagnosed with OG cancer and High Grade Dysplasia from 1 April 2012.

Full details about the new dataset, how to register for the new data collection system and supporting documents are available from the audit website:

• http://www.ic.nhs.uk/og

How to register for the new system;

1. Each user must follow the link to https://clinicalaudit.ic.nhs.uk to register for a Single Sign On (SSO) account
2. Complete the registration form (available from www.ic.nhs.uk/og) with each users details and send to your Caldicott Guardian for approval
3. Your Caldicott Guardian will need to complete their section then submit to This e-mail address is being protected from spambots. You need JavaScript enabled to view it
4. Each user will receive an email confirmation once access to the NOGCA system has been granted to your SSO account
5. Each user can then follow the link https://clinicalaudit.ic.nhs.uk to log into the system using their SSO account details created in Step 1

The 2012 National Oesophago-gastric Cancer Audit Annual Report was published on Monday 2 July and can be accessed from: www.ic.nhs.uk/ogreports

The 2012 Annual Report of the National Oesophago-gastric Cancer Audit (NOGCA), is a continuation of the NOGCA that collected data on patients diagnosed between October 2007 and June 2009.

This report builds on the success of the previous phases, focusing on the results of an organisational audit and on longer-term follow-up and in-depth analysis of data collected in the First NOGCA.

The report highlights positive developments, but also points to potential improvements in selected areas:

• Further changes in the reorganisation of cancer services have been made resulting in fewer and more specialised centres performing a higher volume of oesophago-gastric cancer care than before
• There is substantial variation between Cancer Networks in the proportion of patients diagnosed following GP referral and emergency admission
• Three year follow-up of patients undergoing curative resection demonstrates better results than previously reported in the literature
• Completion rates of patients receiving palliative chemotherapy are low
• Hospital admissions of patients on a best-supportive care pathway are infrequent.

We would like to thank hospitals for the considerable time that their staff devoted to collecting and submitting the data and ask that they continue to do so for the next phases of the NOGCA.

Electronic copies can be downloaded at www.ic.nhs.uk/ogreports. Alternatively, printed copies can be ordered by contacting the HSCIC Contact Centre on 0845 300 6016 or emailing This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

May 2012 Update:

Protocol for changeover from old to new dataset and data collection system

Current process for data collection

The National Oesophago-gastric Cancer Audit recommenced data collection on 1 April 2011. Data collected for patients diagnosed with oesophago-gastric (OG) cancer from 1 April 2011 to 31 March 2012 has been collected using the first OG Audit dataset and submitted via the first OG Audit data collection system. The data submission deadline for this period of data collection is 1 October 2012.

Introduction of new datasets from 1 April 2012

From 1 April 2012, the Audit has been extended to include patients diagnosed with high-grade dysplasia of the Barrett's oesophagus (HGD). This required a revision to the old dataset to include new data items for these patients.

Further information may be found in the document below:

• NOGCA Changeover Protocol  [ 55 kb ]