ArticleCureus2024
Optimizing Urgent Suspected Colon Cancer Referrals and Reducing Colonoscopy Wait Times in Wales.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo assess recent colonoscopies and CT scans in conjunction with the feacal immunochemical test (FIT) for possibly downgrading urgent suspected cancer (USC) referrals.
methodsA retrospective single-centre study was conducted, including all USC referrals for colonoscopy in 2022, excluding anal cancers. The CT and colonoscopy findings for a two-year period prior to the referral, along with the FIT result (if done), were noted. Combinations of tests were used to ascertain if any such combination would predict a negative colonoscopy (no cancer detected).
resultsOut of 500 USC referrals made, 160 were positive for colorectal cancer (CRC). Twelve cases had prior negative CT scans and colonoscopies, and none showed cancer (three were FIT and nine FIT not performed). A total of 54 cases had a prior CT with no FIT, four of which showed cancer. Fifteen cases had a prior CT with a negative FIT, and none showed cancer. Sixteen cases had prior negative colonoscopies, and all were negative for cancer (five negative FIT, one positive FIT, and 10 FIT not done ). Combining the categories where no cancer was missed, potentially 40 referrals could have been downgraded safely (8%).
conclusionsThe above data indicate that, among the patients being considered for a colorectal USC referral, a combined prior negative colonoscopy and CT scan warrants a downgrading of the referral (irrespective of the FIT result). Referrals with a prior negative CT (abdomen) with a negative FIT or normal colonoscopy within the last two years can be safely downgraded. This will have a positive impact on waiting times and monetary expenditure on the USC pathway, but larger studies would be required to prove the external validity of these findings.
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