title: The 'straight to test' initiative reduces both diagnostic and treatment waiting times for colorectal cancer: outcomes after 2 years.
abstract: OBJECTIVE
  This study aimed to determine whether a 'straight to test'(STT) strategy for 2-week wait (2 wk) referrals for suspected colorectal cancer (CRC) reduced the time to diagnosis and treatment for patients with CRC.
  
  
  METHODS
  Consecutive 2-week referrals for suspected CRC over a period of 2 years from February 2007 were analysed. The times to the first diagnostic test and treatment and the cancers identified were analysed for those going to STT or the outpatient clinic.
  
  
  RESULTS
  Of 662 patients having a 2 wk referral, 519 (78.4%) were suitable for the hospital colorectal telephone triage service, 121 (18.3%) patients went to STT and 502 (75.8%) were seen in the clinic. Of these 401 (79.8%) underwent diagnostic tests and 25 (6.2%) had CRC and in 12 (2.9%) patients other cancers were detected. In the STT group, 7 (5.8%) patients were diagnosed with CRC. The median time to first diagnostic test was 12 days (IQR 9-13) in the STT pathway, compared with 23 days (17-31) in those seen in the clinic (P < 0.0001). The median time to first treatment was 40 (32-48) days for those via STT, compared to 46 (28-55) days for those seen in the clinic (P = 0.004). A total of 162 CRC were diagnosed during the study period of whom 34 (20.9%) were 2 wk referrals (5.1% of all suspected CRC 2 wk referrals), and 14 (2.1%) other cancers were detected via this pathway.
  
  
  CONCLUSIONS
  STT speeds up the patient pathway by reducing the time to diagnosis and treatment for patients with CRC.
authors.affiliation: Academic Unit of Medical and Surgical Gastroenterology, Homerton University Hospital NHS Foundation Trust, Homerton Hospital, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Mukherjee
authors.forename: G
authors.initials: G
authors.lastname: Fountain
authors.forename: M
authors.initials: M
authors.lastname: Stalker
authors.forename: J
authors.initials: J
authors.lastname: Williams
authors.forename: T R C
authors.initials: TR
authors.lastname: Porrett
authors.forename: P J
authors.initials: PJ
authors.lastname: Lunniss
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000628:therapy; D019091:Critical Pathways; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012189:Retrospective Studies; D013997:Time Factors; D014218:Triage; D006113:United Kingdom