In July 2000 the government in the United Kingdom introduced a program where patients with suspected bowel cancer have a maximum 2 week wait to see a specialist.
In this study, investigators performed an audit to evaluate the effectiveness of this system.
Mr Michael Thompson's team examined patients referred to 2 week clinics and to routine colorectal surgical outpatient clinics at 1 hospital over a 1 year period.
|Family doctors are still not sure about some of the "high risk" criteria for referral.|
The hospital studied serves a population of 550,000 patients.
During the study period, 249 bowel cancers were diagnosed. Only 26% of these were patients with an urgent 2 week referral.
The team found that of the remaining cases, 16% were diagnosed during routine surgical outpatient clinics. While 22% were diagnosed at other clinics and 35% were emergency admissions.
They determined that 13 patients per week received a 2 week referral to a specialist. Of these, 85% were seen within that time. The diagnosis rate was high, with almost 1 in 10 patients being diagnosed with bowel cancer.
The team suggests that referral criteria are not the problem. Although the team found that family doctors are still not sure about some of the "high risk" criteria for referral.
In addition, they found that 85% of the patients referred to the routine clinics actually met the criteria for urgent 2 week referral.
The team found that referral to a 2 week clinic had little impact on the length of time patients had to wait for treatment, nor was their disease caught at an earlier stage.
This was due to time lags before referral by the family doctor and after the outpatient appointment.