title: An audit of the management of uterine malignancy within the West Midlands. West Midlands Gynaecological Oncology Group.
abstract: OBJECTIVE
  To audit the management of uterine malignancy.
  
  
  METHODS
  Retrospective casenote analysis.
  
  
  METHODS
  Cancer units/centres within the West Midlands.
  
  
  METHODS
  The last 100 cases managed by each hospital in 1997.
  
  
  RESULTS
  Ninety-six cases of uterine malignancy from ten hospitals were analysed. Only six hospitals were able to provide a complete data set. Eighty-eight cases (92%) presented with abnormal, usually postmenopausal, vaginal bleeding. Over 90% of the cases were primary endometrial carcinomas. Of the 15 standards audited, 11 were met by at least one hospital. No hospital met all the standards, although every hospital was able to meet at least one. Standards concerned with initial referral and diagnostic intervals were universally failed. Outpatient diagnosis was made in only 30%. The availability of Rapid Access Clinics neither promoted outpatient diagnosis nor sped up diagnosis. Once the diagnosis had been made, surgery was usually performed within six weeks.
  
  
  CONCLUSIONS
  This audit has provided valuable baseline data for future activity. Serious attention must be given to improvement in clinical cancer data collection. Referral pathways for women with suspected uterine cancer, and endometrial cancer in particular, need improvement. It is recommended that the current standards remain unaltered, and after the West Midlands Gynaecological Oncology Group had the opportunity to consider and implement the necessary changes, the audit be repeated.
authors.affiliation: Academic Unit, North Staffordshire Hospital, Stoke-on-Trent, UK.
authors.forename: C W
authors.initials: CW
authors.lastname: Redman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection / Q000592:standards*; D016889:Endometrial Neoplasms / Q000175:diagnosis; D004739:England; D005260:Female; D006801:Humans; D008485:Medical Audit / Q000379:methods*; D008875:Middle Aged; D011247:Pregnancy; D011787:Quality of Health Care / Q000592:standards; D012017:Referral and Consultation / Q000592:standards; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000175:diagnosis*