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Article History

Received: 1 May 2020

Revised: 29 July 2020

Accepted: 6 August 2020

First Online: 24 August 2020

Ethics approval and consent to participate

: As the National Bowel Cancer Audit involves analysis of data for service evaluation, it is exempt from UK National Research Ethics Committee approval. Section 251 approval was obtained from the Ethics and Confidentiality Committee for the collection of personal health data without the consent of patients. The study was performed in accordance with the Declaration of Helsinki.

: The data used in this study are available from NHS Digital and Public Health England’s Office for Data Release but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. We do not have permission to share the patient-level records used in our analysis.

: The authors declare no competing interests.

: T.E.C. was supported by the Medical Research Council (MR/S020470/1). The National Bowel Cancer Audit is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme, and funded by NHS England and the Welsh Government (www.hqip.org.uk/national-programmes). Neither HQIP nor the funders had any involvement in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.