Upper GI cancer
Patients diagnosed from January 2019 to December 2021

About this release

This release by Public Health Scotland (PHS) presents performance against the National Upper GI Cancer Quality Performance Indicators (QPIs) in the Cancer QPIs dashboard held within the Scottish Cancer Registry and Intelligence Service (SCRIS).

Main points

• There were 1,436 people diagnosed with Upper GI cancer in Scotland in 2021. This is an increase on previous years (1,253 diagnosed in 2020 and 1,340 in 2019).
• The reductions in 2020 numbers are likely to be due to lockdown and social distancing measures implemented due to the COVID-19 pandemic.

NHS Scotland performance against Upper GI Gastric quality performance indicators for 2019, 2020 and 2021. QPI 1 : 95% target not met throughout. QPI 3 : 95% target not met in 19 or 20 but met in 21. QPI 4(i) : 90% target met throughout. QPI 4(ii) : 95% target not met throughout. QPI 5(i) : 95% target not met throughout. QPI 5(ii) : 90% target met throughout. QPI 6 : 80% target not met in 19 or 21 but met in 20. QPI 7(i): 30 day mortality <5% target met throughout. QPI 7(ii): 90 day mortality <7.5% target met throughout. QPI 8: 80% target met in 19 and 20 but not in 21. QPI 9 : 60% target met throughout. QPI 10(ii): 90% target met in 19. 95% target not met in 20 or 21. QPI 11 : 35% target not met throughout. QPI 13: 90% target not met in 19 or 20 but met in 21. QPI 14 : 15% target not met throughout.

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NHS Scotland performance against Upper GI Oesophageal quality performance indicators for 2019, 2020 and 2021. QPI 1 : 95% target not met throughout. QPI 3 : 95% target met in 19 but not met in 20 or 21. QPI 4(i) : 90% target met throughout. QPI 4(ii) : 95% target not met in 19 or 21 but met in 20. QPI 5(i) : 95% target not met throughout. QPI 5(ii) : 90% target met throughout. QPI 6 : 80% target not met in 19 or 20 but met in 21. QPI 7(i): 30 day mortality <5% target met throughout. QPI 7(ii): 90 day mortality <7.5% target met throughout. QPI 8: 90% target not met in 19 but met in 20 and 21. QPI 9 : 60% target not met throughout. QPI 10(i): 70% target met throughout. QPI 10(ii): 90% target met in 19. 95% target not met in 20 or 21. QPI 11 : 35% target not met throughout. QPI 13: QPI not in use in 19. 90% target not met in 20 but met in 21. QPI 14 : 15% target not met throughout.

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• At Scotland level for 2021, the target was met for 14 of the 29 indicators.
• QPI 1, which measures the use of endoscopy for timely diagnosis of Upper GI cancer patients was not met at a national level for all three years. However, the Endoscopy Quality Improvement Plan has recently been relaunched in the West to support improvements in the timely diagnosis of patients.
• Excellent performance against the new, more challenging QPI 5 (ii) indicates that good nutritional support to patients is being provided where need has been identified, although workforce challenges remain for dieticians.
• Levels of mortality following surgical resection within 30 and 90 days were reassuringly low for all three years for both types of cancer.
• Some QPIs have aspirational targets, for example QPI 11 - curative treatment rate. Whilst small incremental improvement may be seen, without significant investment in early detection this target will remain challenging.
• 2021 showed considerable improvements in the timely reporting of HER2 Status (QPI 13).

Background

National cancer quality performance indicators have been developed to support continuous quality improvement in cancer care (CEL 06 2012). NHS Boards are required to report these indicators against a clinically agreed indicator specific target as part of the mandatory national cancer quality programme. They have been developed collaboratively by North Cancer Alliance, South East Scotland Cancer Network, West of Scotland Cancer Network, Healthcare Improvement Scotland and PHS.

Further information

• The Cancer QPIs dashboard is restricted and may be accessed with permission via https://useraccess.nhsnss.scot.nhs.uk
• Network Reports on Upper GI QPIs: NCA, SCAN and WoSCAN
• QPI Definitions and updates on Upper GI Cancer indicators
• PHS QPI Publications

The next release of this publication will be March 2026.