Course Book

Surgery Attachment
Edition 1.0
Royal Hampshire County Hospital, Winchester

BM 3rd Year
2012 / 2013

Student name: ...................

Consultant (s) for major GI block: .

Winchester Surgery Attachment: 3rd year

THIRD YEAR SURGERY ATTACHMENT

WELCOME TO SURGERY

Course Coordinator:

Mr D M Gore
david.gore@hhft.nhs.uk
Ext 5057

Course Administrator: Ms Fiona Holloway

fiona.holloway@hhft.nhs.uk
Ext 5432
Clinical Skills:

Ms Claire Townsend
claire.townsend@hhft.nhs.uk
Ext 4870

Southampton
Marie Marshall
Attachment Administrator: m.e.marshall@soton.ac.uk
Tel: 023 8079 6145

Winchester Surgery Attachment: 3rd year

Introduction
Welcome to the 3rd year Surgery Attachment at Winchester. This booklet will help you get the
most out of your attachment so please read it. Your Surgery Attachment consists of one four
week block of GI Surgery, and one four week block of Combined Specialities (Urology, Breast
Surgery, Vascular Surgery and Accident and Emergency Medicine). These blocks take place
before, after or around the four week Obstetrics and Gynaecology block.

General Advice Regarding This Surgical Attachment

The Royal Hampshire County Hospital may not be a teaching hospital in the traditional sense
but it is certainly a learning hospital. It is busy and you now have the opportunity to get stuck in
and enjoy this great clinical experience. This attachment has been designed to allow you as
much time with patients as possible, and correspondingly you must utilise every learning
opportunity. The word clinical comes straight from the ancient Greek meaning bed, and
it is at the bedside you learn your medicine and surgery. The more closely you follow the
surgical teams, the more you will become part of that team and the more you will learn. Do not
expect to be spoon-fed with formal teaching sessions but do expect to have your questions
answered in clinics, theatre and ward rounds.
The prospect of taking a history from a sick patient may be daunting, but remember that most
patients are fed up with being in hospital and they are usually quite happy to answer your
questions. Indeed most patients recognise the importance of medical training and are willing to
be examined by a student. It goes without saying that you should acknowledge this privilege by
expressing your gratitude.
Each patient is on a journey through their episode of ill health. The more that you see of each
patients journey, the more you will understand about the patient and his/her background, the
disease, the investigations and the treatments. Therefore if you are attending a theatre session,
take time to find out what patients are on the list and get to speak to them beforehand. Likewise
take the trouble to follow their progress post-operatively.
Knowledge of surgical pathology is an essential foundation for your learning, and in particular
you should ensure you are familiar with the natural history of surgical disease (the progress of
that disease untreated). Pathology teaching takes place every Tuesday at 1030 in the Post
Mortem Room, Brinton Wing. This is a valuable learning opportunity.
I.D. BADGES
All Medical Students are required to wear their Southampton University Medical Student
photo ID badge at all times.
To maintain a high standard of infection control the Trust has a policy of bare below
elbows (allowing a plain wedding band as the only jewellery) when working in all clinical
areas.

Winchester Surgery Attachment: 3rd year

The GI Surgery Block

During this attachment you will have four continuous weeks with one GI surgical firm (Colorectal
or Upper GI Surgery). The curriculum has been redesigned to ensure that from Monday to
Thursday you are not distracted by skills sessions or other obligations, and correspondingly you
are expected to be present as part of the team during this block.
Activities on a surgical firm break down into the following:

assessment of new patients (clerking) on the ward or in the Accident and Emergency
department

taking part in ward rounds which usually focus on ongoing evaluation and treatment of
patients known to the team

outpatient clinics in which new and follow-up patients are assessed

special investigations including GI endoscopy (OGD, flexible sigmoidoscopy and

colonoscopy) and imaging (plain radiographs, ultrasound, CT and MR scanning)

anaesthesia and airway management

operating

clinical meetings including multidisciplinary team meetings (MDTMs)

During the GI surgical block you have the opportunity to participate in all of these and you must
make it your business to do so. Your primary obligation is to learn how to take a history,
perform an examination and present the symptoms and signs to a doctor in a coherent manner.
It follows that the more time you spend in the clinical assessment of patients, the better.
Try to see as many of the core GI surgical pathologies as possible (see below). You must make
sure you acquire the following skills:

taking a history with emphasis on GI symptoms

examination of the abdomen (in the elective setting such as in outpatients)

examination of the acute abdomen (when a presents non-electively with abdominal

symptoms and signs)

PR (anorectal) examination

Examination for groin swellings including hernia

Clinical timetables can vary so you must find out from the teams when these sessions take
place and what sessions are best for your learning. The F1 doctors are closest to the ward
patients, but any member of the team should be able to advise you.

Winchester Surgery Attachment: 3rd year

The Combined Specialities Block

You will spend four weeks addressing different surgical specialities. Two weeks on a Urology
firm, then two weeks in Breast Surgery with sessional attachment to Vascular Surgery. The
time available for each is relatively short, so you must indeed utilise every learning opportunity.
This block has been designed to allow you to learn history taking and examination skills relevant
to these important specialities; you may not see all the core surgical pathologies (see below) but
you should address the following skills:

taking a history with emphasis on urological symptoms

palpation of the prostate gland at PR examination

examination of the male external genitalia

understanding dipstick urinalysis

taking a history in the context of breast cancer

breast examination

taking a history in the context of peripheral vascular disease

examination of peripheral pulses in the lower limbs

examination of the abdomen for aortic aneurysm

Formal Evaluation of Your Learning

During your GI surgical block attachment you must complete two pink assessment forms with
different consultants, one from your GI attachment and one from either one of the combined
specialities attachments. You must be prepared to arrange this well in advance so that you can
get this done before your attachment ends. Please collect your pink forms from Fiona Holloway
in the Administration office Education Centre RHCH 01962 825432. There is also an end of
attachment evaluation form which must also be completed and this is also obtained from Fiona
Holloway. Once all forms are completed they must be returned to Fiona. The originals will be
forwarded to School of Medicine and a copy will be kept on file at RHCH.

Log Book
Please get them signed by a senior team member (ST3 or above). These are an integral part of
your end of placement assessment and if not completed may affect your final grade for this
attachment. On completion these books must be submitted to Fiona Holloway to have your
progress recorded. The log book will then be returned to you for your own records.

Winchester Surgery Attachment: 3rd year

Surgical Pathology: Required Knowledge for Medical Undergraduates

You will not see all these conditions, but you must have read about them and so be
knowledgeable about them. Do not expect the formal teaching sessions to cover all, or nearly
all, of these.

GI surgery
Pathologies which can manifest as an acute abdomen are in italics
Pathophysiology of abdominal pain:

Somatic and autonomic innervation pathways

Pain of peritoneal inflammation/irritation and pain of colic

Elective surgical assessment of the abdomen
Evaluation of the acute abdomen

Oesophageal cancer
Oesophageal Varices and portal hypertension
Hiatus hernia

Gastric cancer
Peptic Ulceration including Helicobacter Pylori and NSAIDs
Perforation of peptic ulcer
Gastric outlet obstruction, benign and malignant
Acute upper GI bleeding
Indications for and variants of bariatric surgery (for obesity)

Gallbladder and gallstone disease:

Biliary colic
Cholecystitis
Mucocoele of the gallbladder
Choledocholithiasis
Surgical (extrahepatic) jaundice
Cholangitis
Pancreatitis

Pancreatitis, acute and chronic

Pancreatic cancer

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Indications for splenectomy

Small bowel obstruction
Paralytic ileus
Crohns disease and terminal / regional ileitis
Meckels diverticulum
Mesenteric infarction: embolus and thrombosis
Carcinoid tumours

Appendicitis
Large bowel obstruction
Colorectal cancer = bowel cancer = cancer of colon, cancer of rectum
Colorectal adenoma
Colonic diverticulosis
Colonic diverticulitis (complicated and uncomplicated)
Irritable bowel syndrome and functional bowel disorder
Colitis:
infective including C Difficile and norovirus
Ulcerative
Crohns and indeterminate colitis
Acute fulminant colitis and toxic megacolon
Ischaemic colitis
Acute lower GI bleeding
Stomas: ileostomy and colostomy
Anal fissure
Haemorrhoids
Perianal sepsis and anal fistula
Pilonidal sepsis
Peritonitis presenting as the acute abdomen: differential diagnosis
Abdominal abscess presenting as the acute abdomen: differential diagnosis

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Gynaecological Pathologies Presenting in the Acute Abdomen

Ectopic pregnancy
Miscarriage and threatened abortion
Acute pelvic inflammatory disease (salpingitis)
Ovarian and adnexal torsion
Rupture of endometrioma
Rupture of functional (physiological) ovarian cyst
Abdominal wall hernia
Groin:
Inguinal
Femoral
Obturator
Ventral: Epigastric
Para-umbilical
Incisional

Urology
Renal cell cancer
Bladder cancer
Prostate cancer
Testicular cancer
Bladder outlet obstruction and urinary retention
Benign Prostatic Hyperplasia
Scrotal lumps and bumps
Investigation of Haematuria
Stones: renal, ureteric and bladder calculus
Testicular torsion and urological trauma

Vascular
Peripheral Vascular Disease
Lower Limb Amputation
Carotid Artery Disease, Stroke and TIA
Abdominal Aortic (And Other) Aneurysm
Varicose Veins and Venous Hypertension

Breast
Breast cancer
Breast cancer: triple assessment
Breast cancer screening

Head and neck

Goitre
Thyroid and parathyroid neoplasia
Salivary gland tumours

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Recommended Resources
There are many resources available in local libraries and elsewhere. Some aim to teach clinical
method as well as surgical pathology, and are particularly accessible and relevant. Many are
exhaustive surgical references and I have listed these at the end. Please do not be deterred
from consulting resources outwith these lists.

Podcast: Surgery 101 (available free from iTunes)

This excellent series of podcasts is a great reference for the all the surgical pathology you will
need. They are put together by the University of Alberta. Highly recommended!
www.wessexcolorectalclinic.com
Go to the Patient Information tabs to read the patient information sheets you should have a
firm grasp of all the concepts described.
The Patient Journey tab has some useful links to Enhanced Recovery resources.
The Training tab links to YouTube with many laparoscopic colorectal operation movies (edited
to about 10 minutes!). These will help you make sense of what you see in theatre.

Lecture Notes: General Surgery

Ellis, Calne, Watson
11th Edition 2006: Blackwell Publishing
This is aimed at medical students so well pitched in terms of detail. Compact, very readable
and reliable: highly recommended it is probably the most suitable single text for covering the
undergraduate curriculum. There are very few illustrations, just line drawings.

Clinical method with surgical pathology:

Browses Introduction to the Symptoms and Signs of Surgical Disease
Browse NL, Black J, Burnand KG, Thomas WEG
4th Edition 2005: Hodder Arnold
A clinical classic for proper clinical method. Great Chapter 15: The Abdomen.
Copes Early Diagnosis of the Acute Abdomen
Zachary Cope: revised by William Silen
22nd Edition 2009: Oxford University Press.
A masterly monograph considered unbeatable for learning the art of assessing the acute
abdomen.

Hamilton Baileys Demonstration of Physical Signs in Clinical Surgery

Edited by JSP Lumley
18th Edition 1997: Butterworth Heinemann.

Comprehensive surgical reference books: A treasure trove of clinical wisdom. Full of

images and diagrams relating to surgical pathology of the abdomen and other systems.

Surgery at a Glance
Grace PA, Borley NR
4th Edition, Wiley Blackwell
An excellent and concise tour around clinical presentations and their differential diagnoses, then
surgical pathologies and their key features. Well pitched for undergraduates.

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Principles and Practice of Surgery

Garden, Bradbury, Forsythe, Parks
5th Edition 2007: Churchill Livingstone
Aimed at medical students and FY1. Well illustrated. Good overview of surgery with abdominal
focus. Chapter 8 is useful: Principles of the Surgical Management of Cancer. Comprehensive
organ and system-specific pathology chapters.

Essential Surgery
Burkitt HG, Quick CRG, Reed JB
4th Edition 2007: Churchill Livingstone.
Suitable for both undergraduate and postgraduate students of surgery, and as such probably
best for undergraduates to dip into now and again. Wonderful images.

Clinical Surgery
Cuschieri A, Grace PA, Darzi A, Borley N, Rowley D
2nd Edition 2003: Blackwell
Comprehensive with useful at a glance sections in each chapter.

Bailey and Loves Short Practice of Surgery

Editors: Williams NS, Bulstrode CJK, OConnell PR
25th Edition: Hodder Arnold
This is the big daddy of comprehensive textbooks and covers all kinds of surgery. From an
undergraduate perspective it is one to dip into, not least to benefit from the wonderful anecdote,
eponymous biographies and history which mark it out from the rest.
Single Best Answers for Surgery
Patten DK, Layfield D, Arya S, Leff DR, Paraskevas PA, Darzi A
1st edition 2009: Hodder Arnold
An excellent and challenging test of your surgical knowledge, authored by one of our local core
trainees. In the library.

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COLORECTAL WEEKLY TIMETABLE

AM

Lunch
PM

Monday

Tuesday

Wednesday

Thursday

Friday

08.00 Ward
Round KW

08.00 Ward
Round KW

08.00 Ward
Round KW

08.00 Ward
Round KW

10.00 Business
Meeting
10.30 Grand
Ward Round
(Orthopaedic
Seminar Room,
Bartlett / St Cross
(C983ZY)

09.00 Theatre 2

09.00 OPC
0900 OSFSC

09.00 Theatre
2 (alternate
weeks)
09.00
Endoscopy

08.00 MDT
Meeting
(Xray
Seminar
Room)

14.00
DSU/Endoscopy
(alternate weeks)

14.00 OPC
Follow-up
14.00 Theatre 2

09.00
OSFSC+OPC
10.30 Autopsy
Teaching

09.00
Theatre 2
09.30: Ward
Round

14.00 DSU
14.00 OPC
Follow-up

14.00
Endoscopy

13.00
13.30
Theatre 2

Key:

MDT Multi-disciplinary team

OPC Outpatient Clinic, Lower Outpatients
OSFSC One-stop Flexible Sigmoidoscopy Clinic (Endoscopy Unit, Treatment Centre)
KW Kemp Welch Ward
DSU: Day Surgery Unit, Treatment Centre

Other:

FY1 Bleep: 292 and 061,

Core Trainee (SHO) 298
Speciality Trainee (Registrar) 454
To bleep: 369 bleep number Ext number - ##

Colorectal Surgery (Mr Miles, Mr Gore, Mr Shata, Mr Moore): bowel cancer, diverticular
disease, inflammatory bowel disease, benign anal disease

New patient clinics Tuesday and Wednesday 9am in Treatment Centre Endoscopy Unit,

and usually also concurrently in Lower Outpatients

Operating all day Tuesday, Thursday and Friday (Nightingale Theatre 2)

Colorectal Cancer MDT meeting Friday 8am (Radiology Seminar Room)

FY1 bleep 061 and 292

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UPPER GI WEEKLY TIMETABLE

Monday
Ward round
(08.00 KW)

UPPER GI TEAM TIMETABLE

Tuesday
Wednesday
Thursday
Ward round
Ward round
Ward round
(08.00 KW)
(08.00 KW)
(08.00 KW)

Friday
Ward round
(08.00 KW)

Theatre list
(Nightingale)

Theatre list
(TC)

Theatre list
(Nightingale)

AM
OGD list
(endoscopy)

Theatre list
(TC)

PM

OPC
(outpatients)

Theatre list
(TC)

OPC
(outpatients)

Theatre list
(TC)

Theatre list
(TC)

OGD list
(endoscopy)

Upper GI Surgery (Mr Wakefield, Mr Hou, Mr Szentpali): gallstone disease, surgical jaundice,
groin (inguinal) hernia, cutaneous lumps and bumps.

New patient clinics Monday 2pm Lower Outpatients

Operating all day Tuesday and Friday (Treatment Centre Theatre A)

Upper GI Cancer MDT meeting Monday 8am (Radiology Seminar Room)

FY1 bleep 296

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UROLOGY WEEKLY TIMETABLE

Monday
Week 1:
Introduction

AM

Tuesday
Week 1: Bladder
Outlet
Obstruction/BPH

Week 2:
Renal &
Prostate Ca.

Week 2: Scrotal
lumps & bumps

08.00 Ward
Round KW

08.00 Ward
Round KW

09.00
Theatre 1
(AA)

09.00 Theatre 1
(RR)

Wednesday
Week 1:
Haematuria
Week 2:
Bladder &
testes
cancer
08.00 Ward
Round KW
09.00 TC
Theatre A
(RR)

09.00 OPC (AA)

09.00 Mens
Health Clinic
(DM, RR
every 2/52)

09.00
Urodynamics
(The Mount,
Tina)

09.00
flexible
cystoscopy
(Endoscopy)

Lunch
PM
Key:

09.00
Haematuria
Clinic (USN)
09:00
Theatre 1
(DM)

Thursday
Week 1: Stones

Friday

Week 2:
Trauma/Emergencies

08.00 Ward Round

KW
09.00 TC Theatre B
(AA)

08.00
Discharge
Meeting
(Costa
Coffee)

09.00 Theatre 1 or
Radiology (RR)

08.30 Grand
Ward Round

09.00 Haematuria
Clinic (USN)

09.00 OPC
(AA, RR, DM,
EC)

09.00 Preassessment (The

Mount, FY1 & USN)

09.00 TRUS
& Bx (DM alt.
weeks)

09.00
TWOC
Clinic (DAL)
12.30 MDT
(RSM)
14.00 OPC

12.30 TC
Theatre B (DM)

13.30
Theatre 1
(DM)

14.00 Ward Clerking

14.00 Andover Clinic

14.00 Ward
Clerking

AA Mr Adamson
RR Mr Rees
DM Mr Mclean
EC Mr Chedgy
DAL Discharge & Admissions lounge
MDT Multi-disciplinary team
OPC Outpatient Clinic
KW Kemp Welch Ward
TC Treatment Centre
TWOC Trial without catheter
USN Urology Specialist Nurse
RSM Radiology Seminar Room

Other:
FY1 Bleep: 294: To bleep: 369 bleep number Ext number - ##
Urology (Mr Adamson, Mr Rees, Mr McLean): for examination of the male genitalia, benign
prostatic hyperplasia, calculus, prostate and bladder cancer

General Urology clinics including new patients Monday 2pm, Friday 0930 in Lower

Outpatients.

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Haematuria one-stop clinics run on Wednesday and Thursday 1130 AM (Endoscopy

Room 1, Treatment Centre)

Operating Monday AM, Tuesday AM+PM, Wednesday AM+PM and Thursday AM in

Nightingale Theatres

Operating Tuesday PM , Wednesday AM, Thursday AM in the Treatment Centre (TC)

Urology Multi-Disciplinary Team Meeting (MDTM) for urological cancer: Radiology

Seminar room 1230 Monday

Mens Health Clinic: 0900 Monday, Dept of Sexual Health

Urodynamics: Tuesday PM, Mount Ward

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VASCULAR WEEKLY TIMETABLE

Monday
Week 1:
Introduction

AM

08.00 Theatre
(Southampton)

Tuesday
Week 1:
Hx/Exam of
peripheral
vascular
system
Week 2:
Arterial limb
ischaemia
08.00 Ward
Round KW

Wednesday
Week 1:
Varicose veins
Week 2:
Abdominal
aortic
aneurysms
09.00 Vascular
clinic
2 students

Thursday
Week 1:
Gangrene and
Amputations

Friday
Week 1:
Thomboembolic
disease

Week 2:
Conditions
involving the
spleen

Week 2: Carotid
disease

08.00 Vascular
radiology
meeting XRay
Seminar

08.00 MDT
meeting
(Southampton)

09.00
Consultant WR
10.00-12.00
Paeds clinic
(alternate
weeks)
All day:
Interventional
Radiology (Dr
Page)
Lunch
PM

14.00 Theatre
(Southampton)

14.00 AWMH /
Paed Day case
theatre
(alternate)

Interventional
Radiology (Dr
Page)

14.00 Day
theatre (TC)
(alternate)

Team
Mr N Wilson ext
ST bleep 289
CT/SHO bleep 293
To bleep: 369 bleep number Ext number - ##
Key
MDT Multi-disciplinary team
OPC Outpatient Clinic
KW Kemp Welch Ward
TC Treatment Centre

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BREAST SURGERY WEEKLY TIMETABLE

AM

Monday

Tuesday

Wednesday

Thursday

Friday

07.30 Theatre (alt

weeks only, RMR)

08.00 Ward
Round ATL

08.00 MDT
(Education
Centre)

09.00 New referral

clinic (NP,PA)

09.00 Preassessment
(The Mount,
FY1)

07.30
Theatre (alt
weeks,
RMR)

08.00 Ward
Round ATL
08.00
Theatre (alt
weeks, SL)

09.00 Breast
screening (PA)

09.00 Breast
screening
(PA)

PM

14.00 Theatre (SL,

once a month)

09.00 Follow
up clinic
(SL)
09.00 New
referral clinic
(alt weeks
only, NP)

All day
theatre
(RMR)

09.00 Follow
up clinic
(RMR)
09.00 New
referral clinic
(NP)

09.00 Follow
up clinic
(RMR/SL)

09.00 Breast
screening
(PA)
14.00
Theatre
(SL/NP/RMR)

All day
theatre (alt
weeks, SL)

Key:
ATL
RMR
SL
PP
PA

Anthony Letchworth Ward

Mr Rainsbury
Miss Laws
Miss Paramanathan
Dr Alleyne

Topics:

Breast Cancer
Benign breast disease
Breast examination
Breast triple assessment
Breaking bad news
Multi-disciplinary team working
Endocrine (thyroid/parathyroid)

Other:
SHO bleep: 427
SpR bleep: 288
All clinics are run in Florence Portal House
Breast Surgery (Mr Rainsbury, Miss Laws, Miss Paramanathan): breast cancer and breast
examination. One student per doctor in clinic and examinations. Make sure you attend both
new patient clinics and one breaking bad news clinic. All Clinics are in Florence Portal House
(Clinics run in Andover and are available for teaching also).

New patient clinics

Monday 0900: Miss Paramanathan

o
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Tuesday 0900: Dr Anderson, Miss Paramanathan

Wednesday 1400: Miss Paramananathan (alternate weeks)

Thursday 0900: Miss Paramanathan

Friday 0900: Mr Rainsbury / Miss Laws

Follow-up clinic (breaking bad news)

Wednesday 0900: Miss Laws

Thursday 0900: Mr Rainsbury

Breast screening

Monday 0900: Dr Alleyne

Tuesday 0900: Dr Alleyne

Thursday 0900: Dr Alleyne

Monday 2pm in Florence Portal House

Pre-admission Clinic Tuesday 9am Pre-Admission Clinic, Mount Ward

Operating Wednesdays all day, Thursday 2pm in Florence Portal House

Breast Cancer MDT meeting Education Centre Room 4 Thursday 0800

Breast SHO grade 427

In addition to the inpatient surgical services above, you should be familiar with the range of
anaesthetic interventions commonly used on surgical patients. Most of our patients have an
anaesthetic experience, and anaesthetists are usually very happy to teach. Do not miss out on
this valuable resource.
Furthermore there are several clinical and diagnostic services which will accommodate medical
students on a sessional basis:

Radiology: ensure you are familiar with the common modalities used in evaluation of

abdominal pathology, namely ultrasound and CT scanning. Moreover make sure you are aware
of the imaging modalities used for breast cancer evaluation.

Endoscopy: you should be familiar with OGD (oesophagogastrodudenoscopy), flexible

sigmoidoscopy, colonoscopy and flexible cystoscopy and the demands these studies place on
patients, in particular with regard to oral mechanical bowel preparation in the case of
colonoscopy.
If you have any particular questions, please get in touch via Claire Townsend 01962 824870,
Medical Education Co-ordinator at the Education Centre.
D M GORE AUGUST 2012

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Cancer epidemiology

In 2009 more than 320 000 people were diagnosed with cancer in the UK. In 2010 more than
157 000 people died of cancer. Please make yourself familiar with the following data from
Cancer Research UK, and do use the Cancer Research UK web pages.

Most cancers are carcinomas (cancers of epithelial origin), the exceptions being leukaemia and
lymphomas. While common, non-melanoma skin cancer is not considered in these statistics.
This category consists almost wholly of basal cell carcinoma which does not spread other than
by direct invasion, has a very low mortality rate, is often managed in a community setting and is
incompletely reported.

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10 Most Commonly Diagnosed Cancers: 2009

Numbers of New Cases, Males, UK

Cancer Sites

Cases

Percentage of
all cancer
cases excl
NMSC

Deaths 2010

%
Mortality

Prostate

40841

25.2%

10271

25

Lung

23041

14.2%

19410

84

Bowel*

22711

14.0%

8705

38

Bladder

7632

4.7%

3294

43

Non-Hodgkin Lymphoma

6614

4.1%

2402

36

Kidney

5706

3.5%

2451

43

Malignant Melanoma

5668

3.5%

Oesophagus

5418

3.3%

5105

94

Stomach

4880

3.0%

3102

64

4844
34942

3.0%
21.5%

2526

52

Leukaemia
Other Sites**

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10 Most Commonly Diagnosed Cancers: 2009

Numbers of New Cases, Females, UK

Cancer Sites

Cases

Percentage of all cancer

cases excl NMSC

Deaths

%
Mortality

Breast

48417

30.6%

11556

24

Bowel*

18431

11.7%

7308

40

Lung

18387

11.6%

15449

84

Uterus

7835

5.0%

1937

25

Ovary

6955

4.4%

4295

62

Malignant Melanoma
Non-Hodgkin
Lymphoma
Pancreas

6209

3.9%

5680

3.6%

4232

2.7%

4029

95

Kidney

3580

2.3%

Leukaemia

3458

2.2%

34986

22.1%

Other Sites**
*Bowel including anus (C18-C21)

**4% of all female cases are registered without specification of the primary site

*Bowel including anus (C18-C21)

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