The 2-week wait service: a UK tertiary colorectal centre's experience in the early identification of colorectal cancer
| Autor: | Rikesh Kumar Patel, Talal Altayeb, Shahid Seedat, Adele E. Sayers, Iain Andrew Hunter |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty Time Factors Referral Waiting Lists Colorectal cancer Colonoscopy Nice Contrast Media Risk Assessment Tertiary Care Centers Young Adult Predictive Value of Tests Risk Factors Internal medicine Medicine Humans Young adult Practice Patterns Physicians' Referral and Consultation Sigmoidoscopy Early Detection of Cancer computer.programming_language Aged Retrospective Studies Aged 80 and over Hepatology medicine.diagnostic_test business.industry General surgery Gastroenterology Retrospective cohort study Middle Aged medicine.disease England Predictive value of tests Practice Guidelines as Topic Female Guideline Adherence Barium Sulfate business Colorectal Neoplasms Tomography X-Ray Computed computer Program Evaluation |
| Zdroj: | European journal of gastroenterologyhepatology. 26(12) |
| ISSN: | 1473-5687 |
| Popis: | Objectives National Institute for Health and Clinical Excellence (NICE) guidelines were introduced in the UK to ensure that patients with high-risk symptoms of colorectal cancer were reviewed promptly. We assessed the proportion of patients referred to our department's nurse-led 2-week wait (2WW) clinic with high-risk symptoms or signs that met these guidelines and the rate of colorectal cancer pickup. Patients and methods Patients were identified from a prospectively maintained logbook of 2WW referrals over a 1-year period (1 January 2008-31 December 2008). Computerized notes were reviewed to obtain the following information: referral symptoms or signs and the proportion of patients diagnosed with colorectal cancer. Results A total of 720 patients were seen in the 2WW clinic over this period. Only 356/720 (49.4%) met the referral criteria. The overall pickup rate of colorectal cancer was 52/720 (7.2%) and was not found to be significantly higher in patients meeting guidelines compared with those who did not exhibit these features (7.6 vs. 6.9%; P=0.771). Over the 5-year follow-up period, no patients discharged from the 2WW pathway subsequently re-presented with colorectal cancer. Conclusion Over half of the referrals did not meet the NICE criteria, suggesting that the system is being used as a rapid access route to investigation. Despite this, there is no significant difference in the pickup rate of colorectal cancer in patients with or without high-risk features. Nurse-led 2WW clinics with subsequent investigation appear to be effective in both the identification and exclusion of colorectal cancer. |
| Databáze: | OpenAIRE |
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