How will the Two-Weeks-Wait Rule Affect Delays in Management of Urological Cancers?

• Published in: Journal of the Royal Society of Medicine 2003-08, Vol.96 (8), p.398-399
• Main Authors: Subramonian, K R, Puranik, S, Mufti, G R
• Format: Article
• Language: English
• Subjects: Appointments and Schedules; Biological and medical sciences; Health Services Accessibility - standards; Humans; Medical sciences; National Health Service; Nephrology. Urinary tract diseases; Referral and Consultation - standards; Referral and Consultation - statistics & numerical data; State Medicine; Time Factors; Tumors of the urinary system; United Kingdom; Urinary tract. Prostate gland; Urologic Neoplasms - diagnosis; Waiting Lists
• ISSN: 0141-0768; 1758-1095
• DOI: 10.1177/014107680309600809

The UK National Health Service has now specified a maximum interval of two weeks between general practitioner (GP) referral and specialist assessment for patients with suspected cancer. We examined progress through the cancer pathway in 160 patients with potentially curable cancers of the prostate, bladder, kidney and testis before implementation of this rule. Median intervals with interquartile ranges were quantified from the first GP consultation to hospital referral, then to the first hospital consultation, confirmation of diagnosis and definitive surgery. 34% of patients were seen at the hospital within two weeks of referral. The overall median interval from GP consultation to radical surgery was 137 days, the longest being for prostate cancer (median 244). For prostate, bladder and renal cancers the principal element of delay was from the time of diagnosis to surgery (76, 73 and 26 days respectively). These results indicate that, under the two-weeks-wait rule, 2 out of every 3 patients achieve earlier initial assessment. However, the overall delay will not be substantially reduced without concomitant increases in diagnostic facilities, theatre time and human resources.