title: The 2-week wait referral system does not improve 5-year colorectal cancer survival.
abstract: OBJECTIVE
  The aim of this study was to compare 5-year survival rates in colorectal cancer (CRC) patients who underwent potentially curative surgery before and after the introduction of the 2-week wait (2WW) referral system.
  
  
  METHODS
  Data were collected retrospectively from a prospectively maintained cancer database for CRC patients who underwent surgery in 1999 (pre-2WW group, n = 150) and 2002 (post-2WW group, n = 126). Patients who presented as an emergency, those who died within 30 days of surgery and those who presented with incurable CRC were excluded. We used the Kaplan-Meier method to plot survival curves and the log rank test to compare survival rates between the two groups.
  
  
  RESULTS
  The 5-year survival rates in the pre-2WW and post-2WW groups did not differ significantly (71%vs 72%, respectively; P = 0.880). The number of CRC patients who presented via urgent pathways was higher in the post-2WW group than in the pre-2WW group (77%vs 38%, P < 0.001). Further, owing to this change in the referral pattern, the overall delay between referral and treatment was significantly lower in the post-2WW group than in the pre-2WW group (median 76 days vs 115, P = 0.009).
  
  
  CONCLUSIONS
  The 2WW referral system for patients with symptoms of CRC does not translate into improved survival. However, more patients with symptomatic CRC are being referred via urgent pathways.
authors.affiliation: Good Hope Hospital, Heart of England NHS Trust Warley Medical Centre, Kingsway, Oldbury, UK. ali.zafar@nhs.net
authors.forename: A
authors.initials: A
authors.lastname: Zafar
authors.forename: T
authors.initials: T
authors.lastname: Mak
authors.forename: S
authors.initials: S
authors.lastname: Whinnie
authors.forename: M A S
authors.initials: MA
authors.lastname: Chapman
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000601:surgery; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D006113:United Kingdom; D014850:Waiting Lists