Oesophago-gastric cancer quality performance indicators (QPIs)
Patients diagnosed from January 2022 to December 2024

About this release

This release by Public Health Scotland (PHS) summarises recent national performance, measured using the national Quality Performance Indicators relating to the diagnosis and treatment of Oesophago-Gastric (OG) cancer. This publication was previously for Upper GI (Gastro-Intestinal) QPIs; historically all Upper GI cancers were audited together as part of managed clinical networks across Scotland. They are now audited separately as OG and Hepatobiliary (HPB) cancers.

The aim of the indicators is to ensure that efforts to improve treatment are focussed on improving survival and individual care experience whilst reducing unwarranted variation in treatment and supporting the most effective and efficient delivery of care.

The indicators for all the included cancers were developed by, and periodically undergo formal review by, Healthcare Improvement Scotland (HIS), PHS and the three regional cancer networks (NCA - North Cancer Alliance; SCAN - South East Scotland Cancer Network; and WoSCAN - West of Scotland Cancer Network). Data is gathered and recorded in a central database (eCASE electronic Cancer Audit Support Environment) by specialised cancer audit teams working in NHS Boards.

This dataset includes patients who were diagnosed with OG cancer (see full list of included anatomical sites in the PHS data definitions document) between January 2022 and December 2024.

Main points

• The numbers of patients included in these cancer audit records were:
  • 1,290 patients diagnosed in 2024
  • 1,316 patients diagnosed in 2023
  • 1,379 patients diagnosed in 2022
• At Scotland level for 2024, 14 of the 32 targets were met.

• The results presented within this report illustrate improved performance in recording of TNM at the MDT (QPI 4) and lymph node yield (QPI 8) for oesophageal cancer. Also, levels of mortality following surgical resection within 30 and 90 days were reassuringly low for all three years for both types of cancer.
• There is no improvement in timely diagnosis following endoscopy (QPI 1) despite previous implementation of an Endoscopy Quality Improvement Project. Work is underway to understand how differences in endoscopy pathways are impacting timely diagnosis.
• Performance against QPI 5(i) Nutritional assessment has declined. NHS Boards are working with the appropriate staff to ensure that Malnutrition Universal Screening Tool (MUST) is recorded routinely, preferably at the point of first contact with patients.
• Some QPIs have aspirational targets, for example QPI 11 - curative treatment rate. Without significant effort in early detection, this target will remain challenging.
• Despite not meeting the target in both years since its introduction, there has been improvement in QPI 15(i) PD-L1 status adenocarcinoma (77% in 2023 to 88% in 2024).

Background

The QPIs were put in place to support quality improvement in the treatment of a range of cancers - see About the QPIs. Scottish territorial health boards are required to report their performance against these nationally agreed indicators under the national cancer quality programme - see Scottish Government letter CEL 06 2012. Reporting in this current format was first undertaken in 2012. Performance for other cancers can be found in QPI reports.

Each of the networks release reports in respect of QPI performance in their region for recent years: NCA, SCAN and WoSCAN. In addition, those directly involved in service improvement can access more detailed information through the Cancer QPI Dashboard within SCRIS (Scottish Cancer Registry and Intelligence Service). Due to the level of detail, access is strictly controlled. New users may apply for authorisation via https://useraccess.nhsnss.scot.nhs.uk.

Further information

The next release of this publication will be March 2029.