How has the ‘two‐week wait’ rule affected the presentation of colorectal cancer?

Chohan, D. P. K.; Goodwin, K.; Wilkinson, Sandra E.; Miller, Richard N.; Hall, N. R.

doi:10.1111/j.1463-1318.2005.00821.x

Cited by 61 publications

(92 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There were seventeen case series that involved 38-3119 patients, two rcts that included 478 and 791 patients, and one case-control study that included 177 cases and 162 controls 4,7,[15][16][17][18][19][20][21][22][23][24][25][26][31][32][33][34][35][36] . The update of the literature search identified 823 citations in which patient outcomes related to diagnostic assessment units were described for colorectal cancer in four studies [27][28][29][30] , head-and-neck cancer in two studies 37,38 , lung cancer in two studies 39,40 , gynecologic cancers in three studies [41][42][43] , neurologic cancers in one study 44 , lymph node cancers in one study 45 , and upper gastrointestinal cancers in one study 46 . Study designs included one small rct (88 patients), seven prospective cohort studies (359-3637 patients), and six retrospective studies (69-930 patients) [27][28][29][30][37][38][39][40][41][42]…”

Section: Search Resultsmentioning

confidence: 99%

“…The update of the literature search identified 823 citations in which patient outcomes related to diagnostic assessment units were described for colorectal cancer in four studies [27][28][29][30] , head-and-neck cancer in two studies 37,38 , lung cancer in two studies 39,40 , gynecologic cancers in three studies [41][42][43] , neurologic cancers in one study 44 , lymph node cancers in one study 45 , and upper gastrointestinal cancers in one study 46 . Study designs included one small rct (88 patients), seven prospective cohort studies (359-3637 patients), and six retrospective studies (69-930 patients) [27][28][29][30][37][38][39][40][41][42][43][44][45][46] . Elements of the Downs and Black quality assessment scale for observational studies 14 were used to assess the quality of relevant studies included in the updated review.…”

Section: Search Resultsmentioning

confidence: 99%

“…Only one study evaluated the cost of follow-up visits to general practitioners in an rct evaluating a centralized two-stop rapid assessment unit against conventional routine diagnostic evaluation 39 . Ten studies defined cancer-specific risk criteria for general practitioners to utilize in their risk assessment and decision-making to expedite high-risk referrals to rapid diagnostic units 27,28,30,38,[41][42][43][44][45][46] . Numerous studies evaluated or addressed a multidisciplinary team approach for the rapid diagnostic assessment of cancer [37][38][39][40]43,45 .…”

Section: Discussionmentioning

confidence: 99%

“…For the updated systematic review, all studies but one were undertaken in the United Kingdom and included the National Health Service referral guidelines as a quality performance indicator for improving timely access [27][28][29][30][37][38][39][40][41][43][44][45][46] . Only one study evaluated the cost of follow-up visits to general practitioners in an rct evaluating a centralized two-stop rapid assessment unit against conventional routine diagnostic evaluation 39 .…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Cancer Diagnostic Assessment Programs: Standards for the Organization of Care in Ontario

et al. 2009

View full text Add to dashboard Cite

BackgroundImproving access to better, more efficient, and rapid cancer diagnosis is a necessary component of a highquality cancer system. How diagnostic services ought to be organized, structured, and evaluated is less understood and studied. Our objective was to address this gap. MethodsAs a quality initiative of Cancer Care Ontario's Program in Evidence-Based Care, the Diagnostic Assessment Standards Panel, with representation from clinical oncology experts, institutional and clinical administrative leaders, health service researchers, and methodologists, conducted a systematic review and a targeted environmental scan of the unpublished literature. Standards were developed based on expert consensus opinion informed by the identified evidence. Through external review, clinicians and administrators across Ontario were given the opportunity to provide feedback. ResultsThe body of evidence consists of thirty-five published studies and fifteen unpublished guidance documents. The evidence and consensus opinion consistently favoured an organized, centralized system with multidisciplinary team membership as the optimal approach for the delivery of diagnostic cancer assessment services. Independent external stakeholders agreed (with higher mean values, maximum 5, indicating stronger agreement) that dap standards are

show abstract

Section: Search Resultsmentioning

confidence: 99%

Section: Search Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Cancer Diagnostic Assessment Programs: Standards for the Organization of Care in Ontario

et al. 2009

View full text Add to dashboard Cite

show abstract

“…Thorne et al (17) after checking the information from several papers, demonstrated that only 10.3% of those patients referred following the 2 weeks pathway for a rapid diagnosis of colorectal cancer ended up being diagnosed with cancer, assuming that all entries to the FTDP were correct. This and other studies (18,19) show the poor effectiveness of identifying cancer by using the admission criteria to the diagnostic pathway. This is possibly due to the wrong identification of patients at risk and the unspecific symptoms of CRC.…”

Section: Discussionmentioning

confidence: 99%

Results of implementation of a fast track pathway for diagnosis of colorectal cancer

Vallverdú

Camp

Sáenz

et al. 2011

Rev. esp. enferm. dig.

View full text Add to dashboard Cite

Analysis of Time to Treatment and Survival Among Adults Younger Than 50 Years of Age With Colorectal Cancer in Canada

et al. 2023

View full text Add to dashboard Cite

ImportanceColorectal cancer (CRC) is uncommon in adults younger than 50 years of age, so this population may experience delays to treatment that contribute to advanced stage and poor survival.ObjectiveTo investigate whether there is an association between time from presentation to treatment and survival in younger adults with CRC.Design, Setting, and ParticipantsThis retrospective cohort study used linked population-based data in Ontario, Canada. Participants included patients with CRC aged younger than 50 years who were diagnosed in Ontario between 2007 and 2018. Analysis was performed between December 2019 and December 2022.ExposureAdministrative and billing codes were used to identify the number of days between the date of first presentation and treatment initiation (overall interval).Main Outcomes and MeasuresThe associations between increasing overall interval, overall survival (OS), and cause-specific survival (CSS) were explored with restricted cubic spline regression. Multivariable Cox proportional hazards models were also fit for OS and CSS, adjusted for confounders. Analyses were repeated in a subset of patients with lower urgency, defined as those who did not present emergently, did not have metastatic disease, did not have cross-sectional imaging or endoscopy within 14 days of first presentation, and had an overall interval of at least 28 days duration.ResultsAmong 5026 patients included, the median (IQR) age was 44.0 years (40.0-47.0 years); 2412 (48.0%) were female; 1266 (25.2%) had metastatic disease and 1570 (31.2%) had rectal cancer. The lower-urgency subset consisted of 2548 patients. The median (IQR) overall interval was 108 days (55-214 days) (15.4 weeks [7.9-30.6 weeks]). Patients with metastatic CRC had shorter median (IQR) overall intervals (83 days [39-183 days]) compared with those with less advanced disease. Five-year overall survival was 69.8% (95% CI, 68.4%-71.1%). Spline regression showed younger patients with shorter overall intervals (&lt;108 days) had worse OS and CSS with no significant adverse outcomes of longer overall intervals. In adjusted Cox models, overall intervals longer than 18 weeks were not associated with significantly worse OS or CSS compared with those waiting 12 to 18 weeks (OS: HR, 0.83 [95% CI, 0.67-1.03]; CSS: HR, 0.90 [95% CI, 0.69-1.18]). Results were similar in the subset of lower-urgency patients, and when stratified by stage.Conclusions and relevanceIn this cohort study of 5026 patients with CRC aged younger than 50 years of age in Ontario, time from presentation to treatment was not associated with advanced disease or poor survival. These results suggest that targeting postpresentation intervals may not translate to improved outcomes on a population level.

show abstract

How has the ‘two‐week wait’ rule affected the presentation of colorectal cancer?

Cited by 61 publications

References 8 publications

Cancer Diagnostic Assessment Programs: Standards for the Organization of Care in Ontario

Cancer Diagnostic Assessment Programs: Standards for the Organization of Care in Ontario

Results of implementation of a fast track pathway for diagnosis of colorectal cancer

Analysis of Time to Treatment and Survival Among Adults Younger Than 50 Years of Age With Colorectal Cancer in Canada

Contact Info

Product

Resources

About