A Zafar1, T Mak, S Whinnie, M A S Chapman. 1. Good Hope Hospital, Heart of England NHS Trust Warley Medical Centre, Kingsway, Oldbury, UK. ali.zafar@nhs.net
Abstract
AIM: The aim of this study was to compare 5-year survival rates in colorectal cancer (CRC) patients who underwent potentially curative surgery before and after the introduction of the 2-week wait (2WW) referral system. METHOD: Data were collected retrospectively from a prospectively maintained cancer database for CRC patients who underwent surgery in 1999 (pre-2WW group, n = 150) and 2002 (post-2WW group, n = 126). Patients who presented as an emergency, those who died within 30 days of surgery and those who presented with incurable CRC were excluded. We used the Kaplan-Meier method to plot survival curves and the log rank test to compare survival rates between the two groups. RESULTS: The 5-year survival rates in the pre-2WW and post-2WW groups did not differ significantly (71%vs 72%, respectively; P = 0.880). The number of CRC patients who presented via urgent pathways was higher in the post-2WW group than in the pre-2WW group (77%vs 38%, P < 0.001). Further, owing to this change in the referral pattern, the overall delay between referral and treatment was significantly lower in the post-2WW group than in the pre-2WW group (median 76 days vs 115, P = 0.009). CONCLUSION: The 2WW referral system for patients with symptoms of CRC does not translate into improved survival. However, more patients with symptomatic CRC are being referred via urgent pathways.
AIM: The aim of this study was to compare 5-year survival rates in colorectal cancer (CRC) patients who underwent potentially curative surgery before and after the introduction of the 2-week wait (2WW) referral system. METHOD: Data were collected retrospectively from a prospectively maintained cancer database for CRCpatients who underwent surgery in 1999 (pre-2WW group, n = 150) and 2002 (post-2WW group, n = 126). Patients who presented as an emergency, those who died within 30 days of surgery and those who presented with incurable CRC were excluded. We used the Kaplan-Meier method to plot survival curves and the log rank test to compare survival rates between the two groups. RESULTS: The 5-year survival rates in the pre-2WW and post-2WW groups did not differ significantly (71%vs 72%, respectively; P = 0.880). The number of CRCpatients who presented via urgent pathways was higher in the post-2WW group than in the pre-2WW group (77%vs 38%, P < 0.001). Further, owing to this change in the referral pattern, the overall delay between referral and treatment was significantly lower in the post-2WW group than in the pre-2WW group (median 76 days vs 115, P = 0.009). CONCLUSION: The 2WW referral system for patients with symptoms of CRC does not translate into improved survival. However, more patients with symptomatic CRC are being referred via urgent pathways.
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