The association between referral source and stage of disease in patients with colorectal cancer

• Published in: Colorectal disease 2008-01, Vol.10 (1), p.58-62
• Main Authors: Bevis, P. M., Donaldson, O. W., Card, M., Durdey, P., Thomas, M. G., Sylvester, P. A., Longman, R. J.
• Format: Article
• Language: English
• Subjects: Appointments and Schedules; cancer stage; Colectomy - adverse effects; Colectomy - methods; Colorectal cancer; Colorectal Neoplasms - mortality; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Emergency Treatment; fast track; Female; Humans; Male; Neoplasm Invasiveness - pathology; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Probability; Prognosis; Referral and Consultation - standards; Referral and Consultation - trends; referrals; Registries; Retrospective Studies; Risk Assessment; Statistics, Nonparametric; Survival Analysis; Time Factors; Treatment Outcome; two week rule; United Kingdom
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/j.1463-1318.2007.01222.x

Objective  The colorectal fast track (FT) referral system was set up to ensure patients with suspected cases of colorectal cancer (CRC) received prompt access to specialized services. The aim of this study was to ascertain the association between referral source and the time it took to be seen by a colorectal surgeon to establish whether referral source had any association with the stage of disease at presentation in patients with CRC. Method  Consecutive patients with newly diagnosed CRC presenting between October 2002 and September 2004 were identified retrospectively. Mode of presentation, symptoms, treatment and histopathology data were analysed. Results  Data for 193 patients were analysed. Ninety seven patients (50%) presented via the FT system, 43 (22.5%) from nonfast track outpatient sources (NFT) and 53 (27.5%) as emergencies. NFT patients took significantly longer to be seen by a colorectal specialist than FT patients (median 69 vs 31 days; P