Centralisation of salvage anal cancer surgery in England

Project reference number – 0023

Principal Investigator – Dr Amy Downing

Plain language summary – In 2004, clinical guidance was published by the National Institute for Health and Clinical Excellence (NICE) that said that patients with anal cancer should be managed in specialist hospitals with the right level of expertise.   The guidance stated that surgery should only be used when chemo-radiotherapy has failed to work (called salvage surgery).   It also said that any surgery for anal cancer should be carried out by a small number of surgeons in each hospital who have experience with this type of surgery.  

This project will look at the patterns of surgery for anal cancer across hospitals in England both before and after the guidance was published.  The work will look at the number of patients having salvage surgery, the hospitals where these operations took place, and any changes to these patterns over time.  It will also look at the outcomes of the patients with anal cancer having surgery, such as how long they stayed in hospital after their operation and how many died in the first 30 days after their surgery. The results will be shared with doctors across England to help them review their local hospital policies and organisation of services for patients in their local area.