Lower Gastrointestinal (GI) Cancer
Colorectal cancer, commonly known as bowel cancer, is one of the most prevalent cancers in the UK, with around 44,100 new cases diagnosed each year—approximately 120 cases per day. It is the fourth most common cancer overall, accounting for 11% of all new cancer diagnoses. In both men and women, bowel cancer ranks as the third most common cancer, with around 24,500 new cases in males and 19,600 in females annually.
The GIRFT programme is undertaking a review of lower gastrointestinal surgical performance, with a focus on rectal (lower bowel) cancer. This includes assessing specialist practice, identifying providers of complex procedures like pelvic exenteration, and evaluating service distribution. Key priorities include ensuring appropriate surgical volumes, preventing low-volume activity, delivering a high-quality rectal cancer service, and reviewing stoma reversal rates to support best practice.
We are engaging with multidisciplinary teams across Cancer Alliances, to share insights, drive improvements, and develop actionable recommendations, as well as working collaboratively with stakeholders including the Association of Coloproctology of Great Britain and Ireland and the NHSE Cancer Programme.
- Lower GI Cancer Clinical Lead
Alastair Simpson
Lower GI cancer clinical lead
Alastair Simpson is a consultant colorectal and general surgeon at Nottingham University Hospitals NHS Trust. He is also an honorary associate professor at the University of Nottingham, clinical director of the East Midlands Cancer Alliance and the national speciality advisor to NHS England for cancer surgery.
Alastair graduated from Nottingham University Medical School and completed his early surgical training in the East Midlands, obtaining a PhD in colorectal surgery in 2015. He went on to complete a distinguished Fellowship at the Peter MacCallum Cancer Centre in Melbourne, Australia, in 2016, where he specialised in robotic surgery and advanced cancer surgery.
Alastair is the lead colorectal robotic surgeon at NUH and oversees surgery around the UK. He is also the lead surgeon for advanced colorectal cancer and previously specialised in complex surgery for patients suffering from sarcoma (a rare tumour affecting connective tissue).
In his role as East Midlands clinical director for cancer, Alastair is responsible for leading innovations in cancer pathways and improving outcomes for patients.
Alastair is widely published across a range of specialist areas related to surgery. He currently supervises PhD students at Nottingham University and is the principal investigator for clinical trials.
- Lower GI Cancer Clinical Advisors
Dr Claire Arthur
Lower GI cancer clinical oncology advisor
Dr Arthur became a Fellow of the Royal College of Radiologists in 2012 and was appointed as consultant clinical oncologist at The Christie in Manchester in 2014. Claire has a sub-speciality interest in rectal cancer, which has shaped clinical and research interests in her daily practice.
As a Greater Manchester Colorectal Board Pathway member (2016 – current), Claire has contributed to projects aimed at improving diagnostic and treatment pathways for people diagnosed with bowel cancer in the North-West of England. Her current research roles include national trial management group activities, radiotherapy quality assurance and local Principal Investigator responsibilities for several recent UK rectal cancer trials.
Dr Bruce Fox
Lower GI cancer clinical radiology advisor
Dr Fox has been a gastrointestinal radiologist at University Hospitals Plymouth NHS Trust since 1999, where he is also the LGI multidisciplinary team imaging lead. He introduced and ran the endoscopic ultrasound and colorectal stenting services at the trust.
He has a particular interest in education, holding a variety of roles and contributing to regional and national committees. In 2005, Bruce was central in setting up the pioneering Peninsula Radiology Academy, where he still leads He developed and has led the Royal College of Radiology Case of the Month for over 20 years.
He is also an MD/PhD supervisor and a Fellow of both the Royal College of Physicians and Royal College of Radiologists. In 2020 he was awarded the RCR Exceptional Contribution award.
Bruce is also active in the British Society of Gastrointestinal Radiologists and lectures widely.
Professor Alex Mirnezami
Lower GI cancer surgical advisor
Professor Mirnezami is the professor of surgical oncology at the University of Southampton, and the Associate Medical Director for cancer services and honorary consultant colorectal and general surgeon at University Hospital Southampton.
He has a subspecialist interest in locally advanced and locally recurrent pelvic cancers and is a member of the UK Pelvic Exenteration Network.
He qualified from the University of Southampton and obtained his PhD in the cancer sciences department in 2004, and was subsequently awarded a Cancer Research UK Clinician Scientist Fellowship to conduct post doctoral research in colorectal cancer.
Alex is passionate about developing service transformation and system-wide strategic change, as well as the safe introduction of new techniques and technology.
- Lower GI Cancer Clinical Nurse Specialist
Dr Claire Taylor MBE
Lower GI clinical nurse specialist
Dr Taylor is senior oncology nurse at London North West University Healthcare NHS Trust, having previously served as a Macmillan Nurse Consultant supporting patients undergoing complex colorectal cancer surgery.
With over 30 years of experience in cancer nursing – including a decade as a colorectal cancer clinical nurse specialist at St Mark’s Hospital – Claire has a particular interest in personalised care and the long-term consequences of cancer and its treatment, advocating for approaches that address the holistic needs of patients throughout their cancer journey.
In her national role as chief nursing officer at Macmillan Cancer Support, Claire jointly leads the Centre of Clinical Expertise (CoCE), providing strategic clinical guidance to both internal and external stakeholders.
In recognition of her outstanding contributions to colorectal cancer nursing, Claire was awarded an MBE in February 2020.
Find out more about GIRFT’s data-led approach and best practice resources:
- Lower GI Cancer News