title: Referral guidelines for colorectal cancer--do they work?
abstract: OBJECTIVE
  Urgent referral guidelines for patients with suspected colorectal cancer were introduced in 2000. In a district general hospital, we prospectively assessed the effect of these guidelines on the number of urgent referrals received and the number found to have cancer.
  
  
  RESULTS
  Over the first year, 180 urgent referrals were received of whom 95 (55%) fitted the guidelines. Of these 95 patients, 24 (25%) had colorectal cancer. Conversely, only 2 of the 85 patients (2%) who did not fit the guidelines had colorectal cancer. During the same time period, a total of 145 new cancers were identified within the district of which 119 (82%) were in patients who had not been urgently referred to out-patients as suspected colorectal cancer.
  
  
  CONCLUSIONS
  The guidelines are effective in that patients who fit them have a significant chance of having colorectal cancer. However, the majority of cancers are identified outside the new system. Efforts to reduce delays in diagnosis need to recognise that many patients do not have features which fit published referral criteria. Improved support for general practitioners and better access to specialist services are required to reduce delays in diagnosis.
authors.affiliation: Luton & Dunstable Hospital, Bedfordshire, UK.
authors.forename: A James
authors.initials: AJ
authors.lastname: Eccersley
authors.forename: Elena M
authors.initials: EM
authors.lastname: Wilson
authors.forename: Andreas
authors.initials: A
authors.lastname: Makris
authors.forename: J Richard
authors.initials: JR
authors.lastname: Novell
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000628:therapy; D004630:Emergencies; D004739:England; D005260:Female; D006767:Hospitals, District; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012017:Referral and Consultation / Q000592:standards*