Reduction in the proportion of patients with colorectal cancer presenting as an emergency following the introduction of fast-track flexible sigmoidoscopy: a three-year prospective observational study.
OBJECTIVE
We established a fast-track flexible sigmoidoscopy service to meet the two-week target for colorectal cancer, and have performed a prospective observational study over three years to assess its impact on the proportion of patients with colorectal cancer presenting as an emergency.


METHODS
The fast-track system was established on 1 November 1999 using six screening criteria to select high-risk patients. Data on all high-risk patients referred through the fast-track system and all patients diagnosed with colorectal cancer were recorded prospectively in two time periods: six months before fast-track (1 November 1998 to 30 April 1999, Period 1) and three years following fast-track (1 November 1999 to 31 October 2002, Period 2).


RESULTS
In Period 2, 2294 fast-track referrals were received. A total of 635 cases (321 male, 314 female) of colorectal cancer were diagnosed in Period 2 vs. 84 cases (43 male, 41 female) in Period 1. In Period 1, 30 patients with colorectal cancer (35.7% of the total) presented as an emergency vs. 165 patients (25.9%) in Period 2 (P = 0.059, chi(2)test).


CONCLUSIONS
Introduction of a fast-track service to meet the two-week target has resulted in a trend towards fewer emergency presentations with colorectal cancer.
Davies
R J
RJ
Department of Gastrointestinal Surgery, Taunton and Somerset Hospital, Musgrove Park, Taunton, UK. justindavies2000@yahoo.com
Collins
C D
CD
Vickery
C J
CJ
Eyre-Brook
I
I
Welbourn
R
R
D001071:Appointments and Schedules; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D004630:Emergencies; D005260:Female; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012812:Sigmoidoscopy / Q000379:methods*; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology