The impact of the two-week wait referral pathway on rectal cancer survival

Aim  The aim of this study was to compare the outcome of patients with rectal cancer referred through the two‐week wait (TWW) system with those identified by routine referral pathways (non‐TWW). Method  A prospective study was carried out of 125 consecutive patients diagnosed with rectal cancer betw...

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Bibliographic Details
Published in:Colorectal disease 2012-07, Vol.14 (7), p.848-853
Main Authors: Currie, A. C., Evans, J., Smith, N. J., Brown, G., Abulafi, A. M., Swift, R. I.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Chemoradiotherapy, Adjuvant
Disease-Free Survival
Female
government targets
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Mortality
National Health Service
Neoadjuvant Therapy
Neoplasm Staging
Prospective Studies
Radiotherapy, Adjuvant
rectal cancer
Rectal Neoplasms - diagnosis
Rectal Neoplasms - therapy
Referral and Consultation
referral pathways
Time Factors
United Kingdom
Waiting Lists
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Summary:Aim  The aim of this study was to compare the outcome of patients with rectal cancer referred through the two‐week wait (TWW) system with those identified by routine referral pathways (non‐TWW). Method  A prospective study was carried out of 125 consecutive patients diagnosed with rectal cancer between January 2000 and December 2005 (6 years) in one district general hospital. Data were recorded prospectively in a local clinicopathological registry. The patients were divided into two groups: group 1 (TWW) and group 2 (routine referral pathway). Results  Fifty‐two (41%) of the 125 patients were diagnosed through the TWW (group 1). There was no significant difference in patient demographics, including baseline tumour characteristics, between the two groups. There was no difference in preoperative or postoperative T stage between the two groups (P = 0.63). There was no significant difference in circumferential margin positivity (five of 52 in group 1 vs four of 73 in group 2; P = 0.52) or local recurrence rates (P = 0.37). The 5‐year all‐cause mortality was 49% for group 1 and 52% for group 2 (P = 0.3). The overall disease‐free survival was similar in the two groups (1521 days for group 1 vs 1591 days for group 1, P = 0.29). Conclusion  Referral under the TWW strategy does not translate into improved survival in rectal cancer.
ISSN:1462-8910
1463-1318
DOI:10.1111/j.1463-1318.2011.02829.x