title: The two-week rule for suspected colorectal cancer: patient experience and psychological impact.
abstract: OBJECTIVE
  There has been considerable interest in the "two-week rule" referral pathway efficacy for patients with suspected colorectal cancer. This study aims to explore the psychological impact on these patients.
  
  
  METHODS
  Consecutive patients referred for urgent investigations under the "two-week rule" were invited to take part in semi-structured interviews using interpretative phenomenological analysis (IPA). Interviews were audio-taped, transcribed verbatim and analysed using investigator triangulation to enhance data trustworthiness.
  
  
  RESULTS
  Ten out of 23 (43.5 per cent) patients consented to interviews; none were diagnosed with cancer. Four super-ordinate themes were explored, referring to the "making sense of the threat to health", impact on self, impact on others, reflections on the "two-week rule" referral, and its investigative process. Participants reported their anxiety, fear, vulnerability and coping mechanisms, but also raised concerns about the communication received during the "two-week rule" referral process. Female participants preferred a female endoscopist.
  
  
  CONCLUSIONS
  This study is the first of its kind exploring the psychological effects of the "two-week rule" process for colorectal cancer, highlighting potential areas for improvement in patient information, and satisfaction with the referral process.
authors.affiliation: Clinical and Health Psychology Service, James Cook University Hospital, Middlesbrough, UK.
authors.forename: Nenna
authors.initials: N
authors.lastname: Ndukwe
authors.forename: David W
authors.initials: DW
authors.lastname: Borowski
authors.forename: Angela
authors.initials: A
authors.lastname: Lee
authors.forename: Anne
authors.initials: A
authors.lastname: Orr
authors.forename: Sarah
authors.initials: S
authors.lastname: Dexter-Smith
authors.forename: Anil K
authors.initials: AK
authors.lastname: Agarwal
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D015179:Colorectal Neoplasms / Q000523:psychology*; D004739:England; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D036301:Qualitative Research; D012017:Referral and Consultation; D013997:Time Factors; D014850:Waiting Lists