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 24 June 2018

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News

Fast-track barium enema as the first intervention in suspected colorectal cancer

Fast-track barium enema enables accurate diagnosis and rapid staging of patients with suspected colorectal cancer, claims a team from Bristol, England.

News image

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Specific referral guidelines have been drawn up for patients with suspected colorectal cancer, requiring an outpatient appointment within 2 weeks.

To meet this increased demand, the researchers evaluated the efficacy of fast-track barium enema in the management of such patients.

The findings of the study were reported in the latest issue of the British Journal of Surgery.

Patients with suspected colorectal cancer had a barium enema within 2 weeks, which was double reported by two consultant radiologists.

Patients with a malignancy were booked for a staging CT scan and an outpatient appointment to see a consultant colorectal surgeon.

A letter with the result was faxed to the GP the same day.

Patients without malignancy were referred back to the GP.

Prospective data were obtained on 309 successive patients over a 16-month period.

The mean time from referral was 12 days, and 90% of the patients were seen within 2 weeks.

Benign polyps identified by barium enema in 11% of patients.
British Journal of Surgery

It was found that 38 (12%) patients had a colorectal cancer.

Of these, 36 patients went on to have a CT scan within a mean of 19 days.

Mean time to first clinic appointment was 36 days.

Referrals increased over each 4-month period (66, 60, 71, and 112), but the percentage of positive barium enemas remained similar (15%, 10%, 13%, and 12%).

The investigators found that there was only 1 false-negative examination.

Furthermore, radiologically benign polyps alone were shown in 11% of patients.

Dr P. Sylvester, of the Bristol Royal Infirmary, said on behalf of fellow authors, "The provision of specialist radiology as the first intervention has enabled accurate diagnosis and rapid staging of patients with suspected colorectal cancer."

"In addition, fast-track barium enema has reduced the impact of the 2-week wait on the outpatient management of benign colorectal conditions," it was concluded.

Br J Surg 2002; 89 (s1): 5
21 May 2002

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