National root cause analysis to reduce missed cancer after endoscopy
Research type
Research Study
Full title
Reducing the rate of missed diagnoses of oesophageal and gastric cancers during endoscopy through endoscopy provider root cause analysis of potentially missed cancers
IRAS ID
328295
Contact name
Nigel Trudgill
Contact email
Sponsor organisation
SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Aims
We want to find out why cancer may not be found during endoscopy (flexible telescope examination of the oesophagus (gullet) and stomach), to reduce the risk in future.
Background
15,800 people in the UK are diagnosed with oesophageal or stomach cancer annually. Approximately 1200 per year had an endoscopy that did not find their cancer in the three years before diagnosis. This is known as post-endoscopy upper gastrointestinal cancer or ‘missed’ cancer. Missing cancers is bad, as the earlier they are identified, the more treatable they are and the better the outcome. This research is needed to find out why cancer is missed at endoscopy, tackle differences between hospitals and reduce missed cancers.Design and methods
We have experience of using routine NHS data to identify missed cancers that occurred in the past. However, to make a difference to endoscopy now, we need to identify and investigate missed cancers as soon as possible.
This project will
1. Adapt methods we have used successfully to identify and investigate missed bowel cancers. When a new potentially missed oesophageal or stomach cancer is found, we will tell the hospital who did the endoscopy and ask them to review the records in detail to understand why it was missed (root cause analysis).
2. Pool the results of these detailed analyses of missed cancers nationally to understand the common reasons for missing cancers. Use these results to get the NHS to take steps to limit missing cancers in future.
Dissemination
National organisations responsible for endoscopy standards will encourage participation through the external approval of endoscopy units and share learning.REC name
North West - Preston Research Ethics Committee
REC reference
23/NW/0193
Date of REC Opinion
18 Jun 2023
REC opinion
Favourable Opinion