title: Results of implementation of a fast track pathway for diagnosis of colorectal cancer.
abstract: BACKGROUND
  fast track pathways for diagnosis of cancer intend to decrease delays in diagnosis and treatment of cancer. It is recommended to initiate treatment in a period no longer than 30 days since admission in these circuits.
  
  
  OBJECTIVE
  to know the characteristics and fluency of our Fast Track Diagnostic Pathway (FTDP) for Colorectal Cancer (CRC), with special attention to those patients selected for surgical treatment as a first choice.
  
  
  METHODS
  all patients who entered the FTDP for CRC during a period of 2 years (2008-2009) were analyzed as well as the rest of patients also diagnosed with CRC but never seen in the FTDP.
  
  
  RESULTS
  of the 316 patients referred to the FTDP only 78 (24.7%) were diagnosed as having some kind of cancer derived from the digestive system. At the end 61 patients (19.3%) were diagnosed with CCR. The time interval from entry into the FTDP to the first hospital visit was 3 days (range 1-8), and the interval until colonoscopy was performed was 11.5 days (range 1-41). Fourteen (41.1%) of those patients chosen for surgery were operated on in a period lesser than 30 days while 28 patients (82.3%) underwent surgery before day 45 since admission into the circuit.
  
  
  CONCLUSIONS
  though the functioning of the FTDP is acceptable, any increase in number of patients can generate delays. For this reason it is advisable to have a team to assure a good functioning of the FTDP. A proper follow-up of the whole process will possibly avoid unnecessary delays and it will improve coordination of the different phases of the fast track pathway and treatment. As the diagnostic outcome is poor it is mandatory to implement alternatives programs like screening of asymptomatic population, allowing an early detection of this condition.
authors.affiliation: Department of General Surgery, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain. helena.vallverdu@pssjd.org
authors.forename: Helena
authors.initials: H
authors.lastname: Vallverdú-Cartié
authors.forename: Jordi
authors.initials: J
authors.lastname: Comajuncosas-Camp
authors.forename: Rolando A
authors.initials: RA
authors.lastname: Orbeal-Sáenz
authors.forename: José Luis
authors.initials: JL
authors.lastname: López-Negre
authors.forename: Pedro J
authors.initials: PJ
authors.lastname: Gris Garriga
authors.forename: Jaime
authors.initials: J
authors.lastname: Jimeno-Fraile
authors.forename: Judit
authors.initials: J
authors.lastname: Hermoso-Bosch
authors.forename: C
authors.initials: C
authors.lastname: Sánchez-Pradell
authors.forename: Sandra
authors.initials: S
authors.lastname: Torra-Alsina
authors.forename: Joan
authors.initials: J
authors.lastname: Urgellés-Bosch
authors.forename: David
authors.initials: D
authors.lastname: Parés
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D019091:Critical Pathways; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D013997:Time Factors