The Victorian Colorectal Cancer Advisory Group was formed after the Colorectal Cancer 2018 Summit held in March last year, to ensure that findings and conclusions of this repeat summit were acted upon. Members of the group present progress of local investigations into summit-identified variations at meetings, in order for learnings to be shared and opportunities for further collaboration found.
Barwon South Western Region Integrated Cancer Service (BSWRICS–Geelong) identified two variations as a priority from the Colorectal 2018 Summit. These were:
- A lower proportion of patients receiving adjuvant chemotherapy intravenously within eight weeks of surgery for stage III colon cancer
- Over 50% of rectal cancer cases treated in the BSWRICS region having their documented multidisciplinary team meeting (MDM) discussion after their treatment.
These variations were investigated to ascertain whether the variations were a true reflection of patient treatment, and if so, whether the variations were unwarranted. This involved three pieces of work:
- Comparative analysis using regional ECO Clinical Registry (01 Jan 2011–31 Dec 2015)
- Clinical audit of stage III colon cancer patients (01 Jan 2013–31 Dec 2015) who did not receive adjuvant intravenous chemotherapy
- Audit of rectal cancer patients (diagnosed between 01 Jan–31 Dec 2017) for evidence of a documented MDM treatment plan.
Findings of the comparative analysis confirmed that the utilisation of adjuvant chemotherapy (oral and intravenous) for stage III colon cancer patients does appear lower compared to other health services.
For the clinical audit, it was found that patients not receiving adjuvant intravenous therapy had one or more of the following reasons documented:
- Adjuvant capecitabine
- Significant comorbidities
- Advanced age
- Declined treatment
- Deceased shorty after surgery.
The colorectal MDM audit data was analysed at an individual health service level, indicating some opportunities for improvement in increasing the percentage of documented prospective MDM treatment planning for rectal cancer patients. Follow-up is occurring with health services.
Colorectal multidisciplinary team members have been tasked with further investigating the utilisation and timeliness of adjuvant therapy (oral and intravenous) for stage III colon cancer patients.
2018 CRC Summit videos below.
Read the progress on the 2014 Colorectal Cancer Summit outcomes, Optimal Care Pathway implementation efforts and colorectal cancer data (2011-2015) in our related documents below.
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The clinical working party co-chaired by Mr Brian Hodgkins and Dr Geoff Chong was re-formed to oversee the Victorian Colorectal Cancer (CRC) Summit for 2018. Over 60 multidisciplinary colorectal cancer clinicians attended the 2nd CRC Summit in Melbourne on 16 March.
Discussion topics were:
- How are we tracking with colorectal cancer multidisciplinary care in Victoria?
- The quality of colorectal cancer care in Victoria: review of data
- Developments in screening, colonoscopies and early diagnosis of colorectal cancer
Summits are usually filmed to provide ongoing resources for clinicians.
Professor Robert Thomas, Chair, Australia's Cancer Advisory Council, opened the summit:
Ms Kathryn Whitfield, Assistant Director of Cancer Strategy and Development at the Department of Health and Human Services, provided an update on progress since the 2014 Colorectal Summit:
Working party cochair Mr Brian Hodgkins, Colorectal Surgeon, Monash Health, presented colorectal cancer data (2011-2015):
Dr Zee Wan Wong, Peninsula Health; Mr Brian Hodgkins, Monash Health; working party cochair Dr Geoff Chong, NEMICS & GICS, spoke on clinician-led initiatives to investigate and improve variations: