Significant Polyps and Early Colorectal Cancer – SPECC
Thanks to excellent guidance from our steering group we started the SPECC National Development Programme workshops in London in November 2015. Since then we have run 14 more workshops across England, Wales, Scotland and Ireland – making it an international programme.
The aims of the programme were to:
- Define a significant polyp and identify an early colorectal cancer
- Recognise a SPECC and how this is best achieved
- Document and describe SPECC to better aid multi-disciplinary decision making
- Plan carefully – ‘think twice and cut once’, making sure that the first shot it the best as these are ‘high value lesions’. Careful decision making about the use of biopsy and whether they add value. Take time and use regional and national resources, refer to experts – ‘another day, another endoscopist, another hospital’
- Treatment – first treatment gives the best outcome. Low risk lesions can be safely removed endoscopically. MDT decision must include expert endoscopist
There was a core faculty of 10 with another 90 specialists joining the SPECC faculty to help with presentations and case studies.
1,237 clinicians attended a workshop over the 25 months that the programme ran. These people came from 178 hospitals in England, Wales, Scotland, Northern Ireland and Ireland. A third of those attending were consultant surgeons.
The programme was free for 6 core members of each colorectal MDT as long as this included a surgeon, gastroenterologist, pathologist, radiologist and specialist nurse.
Feedback:
‘Very interesting, well organised, fascinating’
‘Very high standard of talks & discussion’
‘Imaging and precision improves definitive treatment’
‘Think twice, cut once’
‘Super informative day – well done Pelican’
‘This was an excellent meeting and a lot of very interesting topics – valuable information for MDT management’
‘More awareness of polyp presentation and input of MDT in management decisions’
Achievement
Nearly every hospital throughout the UK and Ireland has now spent time considering this small but challenging cohort of patients who present with SPECC. The multi-disciplinary members of the MDT have a greater awareness of the difficulties and uncertainties that SPECC present and will have more confidence within their MDT discussion about the local treatments available and where to refer if need be.
Finally – we would like to thank everyone for their help. This programme was supported mainly by the generosity of Pelican charitable donations. We are very grateful for industry sponsorship – Norgine supported all of the workshops, Exact Sciences, Medtronic and Applied Medical also attended a small number of meetings.
Publication
Following the completion of the SPECC programme, we were delighted to work with members of the Faculty to compile a supporting supplement for publication – https://onlinelibrary.wiley.com/toc/14631318/2019/21/S1. The publication is 65 pages, made up of 16 supplement articles and the key messages from the Faculty. It is in Free Access format, allowing anyone to view and download the papers, ensuring that the key reference points from the national programme are available for everyone to read.
