title: Impact of the United kingdom national bowel cancer awareness campaign on colorectal services.
abstract: BACKGROUND
  Poor public awareness may account for the advanced stage at diagnosis, hence, poorer survival. With the aim of reducing colorectal cancer deaths, the United Kingdom National Bowel Cancer Awareness Campaign was rolled out from January 2012. Currently, the United Kingdom government target is to have all patients suspected to have cancer seen within 2 weeks of referral from general practitioners. This has significant impact on the workload for endoscopists.
  
  
  OBJECTIVE
  The study aimed to measure the impact on colorectal services following the National Bowel Cancer Awareness Campaign.
  
  
  METHODS
  The data between February and July 2012 (onset of campaign) were prospectively collected and compared with data retrospectively collected between February and July 2011 inclusive (before campaign).
  
  
  METHODS
  This study was conducted at a single center, university hospital.
  
  
  METHODS
  The number of 2-week wait referrals, investigations, and colorectal cancers detected were assessed.
  
  
  METHODS
  Demographics, staging, and treatment of cancers were compared between groups along with the uptake of colorectal cancer screening.
  
  
  RESULTS
  The total number of 2-week wait referrals increased by 47% with a resultant 38% increase in colonic investigations (p = 0.034) and a 23% increase in cancers detected (p = 0.0157). There was a 6.5% increase in the uptake of screening (p = 0.001) and a 62.5% decrease in the number of patients with colorectal cancer presenting as an emergency.
  
  
  CONCLUSIONS
  This short period of study is a major limitation. Although the data were from prospectively maintained databases, some data were analyzed retrospectively. Because only a single unit was assessed, results across a wider population may be more pronounced. There was also a referral bias in the compliance of primary care in the adherence to the 2-week wait referral criteria, because these criteria can be abused to get anxious patients into secondary care quickly.
  
  
  CONCLUSIONS
  The National Bowel Cancer Awareness Campaign significantly increased the demand for colorectal services. With a potentially more favorable oncological outcome, further evaluation of supporting this greater workload demand is warranted.
authors: Department of Colorectal Surgery, University Hospitals of Coventry and Warwickshire, Coventry, United Kingdom.
authors: R
authors: R
authors: Pande
authors: E
authors: E
authors: Leung
authors: P
authors: P
authors: McCullough
authors: S
authors: S
authors: Smith
authors: C
authors: C
authors: Harmston
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006293:Health Promotion; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D015397:Program Evaluation; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D006113:United Kingdom