Many colorectal Ca patients miss two-week referral rule
By Emma Wilkinson
Three-quarters of patients with colorectal cancer are missing out on urgent referral under the Government's high-profile two-week deadline, research shows.
An audit of 249 newly diagnosed bowel cancer cases in Portsmouth found just 26 per cent had been referred under the two-week rule. Some 35 per cent were emergency admissions, 16 per cent were referred non-urgently to bowel disease clinics and 22 per cent were diagnosed at other outpatient clinics.
Among the patients whose cancer was diagnosed at routine outpatient clinics, 85 per cent met the criteria for the deadline and should have been referred urgently, according to a report in Gut (February).
But the researchers said the audit suggested the Government's urgent referral criteria were valid as 9.4 per cent of two-week referrals had cancer compared with 2.2 per cent of those referred to routine colorectal surgical outpatient clinics.
Research leader Mr Mich-ael Thompson, consultant in the colorectal unit at Queen Alexandra hospital, Ports-mouth, said it was disappointing that more than 50 per cent of cancer patients who met the two-week rule were not referred urgently.
But he stressed GPs should not necessarily take the blame. 'Until the reasons are determined it should not be assum-ed all of these patients were incorrectly referred,' he said.
Mr Thompson, a co-author of the national urgent referral guidelines for suspected colorectal cancer, said the only way to ensure all cases were picked up quickly was to provide extra resources so all patients with lower gastrointestinal symptoms could be seen within two weeks.
Dr Nick Summerton, a GP in Hull who has advised the Government on cancer referrals, said: 'The results are sadly predictable – the fundamental problem is that the guidelines are wrong.'
The urgent referral criteria were based on evidence from hospital clinics rather than primary care, said Dr Summerton, senior lecturer in primary care medicine at the University of Hull. He added: 'The whole thing is a bit of a mess and I'm not convinced the two-week rule has helped.'