ArticleGut2004
The Department of Health's "two week standard" for bowel cancer: is it working?
Article in Gut, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Conflicting Guidelines: A Systematic Review on the Proper Interval for Colorectal Cancer Treatment.World journal of surgery · 2021Pooled it
- Systematic review of clinical features of suspected colorectal cancer in primary care.Canadian family physician Medecin de famille canadien · 2014Pooled it
- Guideline for referral of patients with suspected colorectal cancer by family physicians and other primary care providers.Canadian family physician Medecin de famille canadien · 2014Pooled it
- Value of symptoms and additional diagnostic tests for colorectal cancer in primary care: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2010Pooled it
- The effects of the Two-Week Rule on NHS colorectal cancer diagnostic services: a systematic literature review.BMC health services research · 2006Pooled it
- Review
- Factors Contributing to Delay in Specialist Care After Colorectal Cancer Diagnosis in Kentucky.The Journal of surgical research · 2021Article
- Straight-to-test for the two-week-wait colorectal cancer pathway under the updated NICE guidelines reduces time to cancer diagnosis and treatment.Annals of the Royal College of Surgeons of England · 2019Article
- Gene expression profile comparison between colorectal cancer and adjacent normal tissues.Oncology letters · 2017Article
- Has the 'Fast-Track' referral system affected the route of presentation and/or clinical outcomes in patients with colorectal cancer?World journal of surgical oncology · 2016Article
- Clinical review: surgical management of locally advanced and recurrent colorectal cancer.Langenbeck's archives of surgery · 2014Review
- The Two-Week Referral System for colorectal cancer--not fit for purpose.International journal of colorectal disease · 2013Article
- Assessing the value of matrix metalloproteinase 9 (MMP9) in improving the appropriateness of referrals for colorectal cancer.British journal of cancer · 2013Article
- Is the "red flag" referral pathway effective in diagnosing colorectal carcinoma?The Ulster medical journal · 2012Article
- Emergency first presentation of colorectal cancer following air travel: a case series.JRSM short reports · 2011Article
- Was there shortening of the interval between diagnosis and treatment of colorectal cancer in southern Netherlands between 2005 and 2008?World journal of surgery · 2010Article
- Article
- Cancer diagnostic assessment programs: standards for the organization of care in Ontario.Current oncology (Toronto, Ont.) · 2009Article
- Referral letters for 2-week wait suspected colorectal cancer do not allow a 'straight-to-test' pathway.Annals of the Royal College of Surgeons of England · 2009Article
- Fast track referral for cancer.BMJ (Clinical research ed.) · 2007Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the effectiveness and efficiency of the Department of Health's new general practitioner referral guidelines for bowel cancer.
designOne year prospective audit.
settingDistrict general hospital serving a population of 550 000. SUBJECTS: All patients with bowel cancer; all patients referred on the basis of the two week standard and to a routine colorectal surgical outpatient clinic.
main outcome measuresProportion of cancers referred on the basis of the two week standard and to other colorectal clinics; the proportion with the higher risk criteria and their diagnostic yields; stage of cancers diagnosed in outpatient clinics; and time to treatment.
resultsA total of 249 cancers were diagnosed in the index year. Sixty five (26.1%) were referred to two week standard clinics, 40 (16.1%) to routine colorectal surgical outpatient clinics, 54 (22%) to other clinics, and 88 (35.3%) were emergencies. Thirteen patients per week were referred to the two week standard clinics and 85% (54/65) of cancers so referred were seen within two weeks. The diagnostic yield of cancer in the two week standard clinic was 9.4% (65/695) compared with 2.2% (40/1815) in the routine colorectal surgical outpatient clinic (p<0.0001). Eighty five per cent of patients with cancer referred to outpatients matched the guidelines for the two week standard clinics. Only 46% of this group were so referred. Overall, delay to treatment and Dukes' stage were not improved in patients diagnosed in the two week standard clinics.
conclusionsMost patients with bowel cancer were not referred on the basis of the two week standard although most fulfilled the referral criteria, which had higher diagnostic yields. The two week standard clinics did not shorten the overall time to treatment or improve the stage of disease because the time lags before referral and after the outpatient appointment are the major causes of delay in the bowel cancer patient's journey.
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