AIM: Primary care referral for patients with bowel symptoms is triaged by general practitioners to urgent or routine based on the clinical suspicion of malignancy. Triage directly influences time to assessment and investigation. This study aimed to establish whether urgency of referral of patients with large bowel malignancy has any effect on management. METHOD: An analysis was undertaken of all patients with colorectal cancer referred by primary care and discussed at the regional colorectal multi-disciplinary team (MDT) meetings from January 2009 to December 2010. Demographics and tumour data were collated prospectively from MDT records, and operation and investigation reports. RESULTS: Of 369 primary case referrals with colorectal cancer, 303 (82.1%) were urgent and 66 (17.9%) routine. Patient characteristics (age, sex, American Society of Anesthesiologists grade) and resection rates were similar in both groups and no significant difference in tumour location was observed. The time from referral to diagnosis was significantly longer in the routine group (mean 73.7 days vs 30.2 days; P = 0.001). Dukes stage was less advanced for the routine referral group, (P = 0.002). CONCLUSION: Urgency of referral decreased the time to diagnosis. This did not influence resection rates. Dukes stage was higher for urgent referrals. Long-term follow-up is required to determine any impact on survival.
AIM: Primary care referral for patients with bowel symptoms is triaged by general practitioners to urgent or routine based on the clinical suspicion of malignancy. Triage directly influences time to assessment and investigation. This study aimed to establish whether urgency of referral of patients with large bowel malignancy has any effect on management. METHOD: An analysis was undertaken of all patients with colorectal cancer referred by primary care and discussed at the regional colorectal multi-disciplinary team (MDT) meetings from January 2009 to December 2010. Demographics and tumour data were collated prospectively from MDT records, and operation and investigation reports. RESULTS: Of 369 primary case referrals with colorectal cancer, 303 (82.1%) were urgent and 66 (17.9%) routine. Patient characteristics (age, sex, American Society of Anesthesiologists grade) and resection rates were similar in both groups and no significant difference in tumour location was observed. The time from referral to diagnosis was significantly longer in the routine group (mean 73.7 days vs 30.2 days; P = 0.001). Dukes stage was less advanced for the routine referral group, (P = 0.002). CONCLUSION: Urgency of referral decreased the time to diagnosis. This did not influence resection rates. Dukes stage was higher for urgent referrals. Long-term follow-up is required to determine any impact on survival.
Authors: Antonieta Medina-Lara; Bogdan Grigore; Ruth Lewis; Jaime Peters; Sarah Price; Paolo Landa; Sophie Robinson; Richard Neal; William Hamilton; Anne E Spencer Journal: Health Technol Assess Date: 2020-11 Impact factor: 4.014
Authors: Chanpreet S Arhi; Elaine M Burns; Alex Bottle; George Bouras; Paul Aylin; Paul Ziprin; Ara Darzi Journal: Br J Gen Pract Date: 2020-06-25 Impact factor: 5.386
Authors: R D Neal; P Tharmanathan; B France; N U Din; S Cotton; J Fallon-Ferguson; W Hamilton; A Hendry; M Hendry; R Lewis; U Macleod; E D Mitchell; M Pickett; T Rai; K Shaw; N Stuart; M L Tørring; C Wilkinson; B Williams; N Williams; J Emery Journal: Br J Cancer Date: 2015-03-31 Impact factor: 7.640