NICE updates guidance for colorectal cancer

Feb 24, 2020

The National Institute for Health and Care Excellence (NICE) has published updated guidance for colorectal cancer.

The guideline covers managing colorectal cancer in people aged 18 and over. It aims to improve quality of life and survival for adults with colorectal cancer through management of local disease and management of secondary tumours (metastatic disease).

It is for healthcare professionals, Cancer Alliances Commissioners of colorectal cancer preventative and treatment services (including clinical commissioning groups and NHS England Specialised Commissioning), and people with colorectal cancer and their families and carers.

This updated guidance for colorectal cancer includes recommendations on:

Speaking about the updated guidance, Dr Lisa Wilde, Director of Research and External Affairs at Bowel Cancer UK, said: “The NICE guidance is an essential part of ensuring patients with bowel cancer have access to the best treatment and care.  Today’s updated guidance reflects some significant advances that have been made over the past five years.

“It is pleasing to see that a number of the recommendations made by the charity have been included in the updated guidance, and we will continue to work with patients, clinicians and NICE to ensure that the guidance is adopted by hospitals across the country.”

Colorectal cancer (cancer of the colon or rectum, or bowel cancer) is the fourth most common cancer in the UK, with over 41,000 new cases diagnosed each year according to Cancer Research UK. Risk factors include increasing age, genetics and family history (particularly syndromes such as familial adenomatous polyposis and Lynch syndrome), inflammatory bowel disease and other dietary and lifestyle factors. Survival rates have improved over time, with almost 60% of people diagnosed with colorectal cancer surviving for at least five years. Survival is linked to disease stage at presentation, with better survival the earlier the disease is detected and treated.

People with Lynch syndrome have an increased risk of colorectal cancer, with lifetime risk estimated to be between around 50% to 80%. The main strategy to prevent colorectal cancer in people with Lynch syndrome has been regular screening with colonoscopy and polypectomy. Aspirin has been suggested as another potential prevention strategy for colorectal cancer.

Diagnosis and staging of colorectal cancer are well established with histology and appropriate imaging, and are not covered by the guideline.