[Modified British model shortened lead times for CT scans of the colon].
The British national Institute for Health and Care Excellence (NICE) has presented guidelines based on signs and symptoms which should raise a suspicion of colorectal cancer. A slightly modified version of these guidelines, adapted to Swedish conditions, named Swedish NICE (sNICE) criteria, was implemented at eight primary care centres. By following the sNICE criteria, cases with higher degree of suspicion of colorectal cancer were advised for computer tomography (CT) of the colon, whereas cases of low degree of suspicion were advised for the considerably less time and patient demanding CT of the abdomen. For patients with isolated anal symptoms without presence of sNICE criteria, active expectancy for six weeks was recommended, followed by renewed consideration. Results showed that the ratio between CT colon and CT abdomen was reduced from 2.2 to 1.1 after introduction of the sNICE criteria. Also, the proportion of patients undergoing CT colon within two weeks from admittance was increased from 3 to 25 %. We conclude that the sNICE criteria may be a useful supportive tool for the primary care physician.
Vårdcentralen Kärna - Region Östergötland Linköping, Sweden Vårdcentralen Kärna - Region Östergötland Linköping, Sweden.
Magnus
M
Falk
Universitetssjukhuset i Linköping - Kirurgiska kliniken Linköping, Sweden Universitetssjukhuset i Linköping - Kirurgiska kliniken Linköping, Sweden.
Rune
R
Sjödahl
FoU-enheten för närsjukvården i Östergötland - Linköping, Sweden FoU-enheten för närsjukvården i Östergötland - Linköping, Sweden.
Ann-Britt
AB
Wiréhn
Region Östergötland - Utvecklings- och patientsaökerhetsenheten Linköping, Sweden Region Östergötland - Utvecklings- och patientsaökerhetsenheten Linköping, Sweden.
Marie
M
Lagerfelt
Universitetssjukhuset i Linköping - Radiologiska kliniken Linköping, Sweden Universitetssjukhuset i Linköping - Radiologiska kliniken Linköping, Sweden.
Mischa
M
Woisetschläger
Region Östergötland - Vårdcentralen Kungsgatan Linköping, Sweden Region Östergötland - Vårdcentralen Kungsgatan Linköping, Sweden.
Ulla
U
Ahlström
Universitetssjukhuset i Linköping - Kirurgiska kliniken Linköping, Sweden Universitetssjukhuset i Linköping - Kirurgiska kliniken Linköping, Sweden.
Pär
P
Myrelid
D003106:Colon / Q000000981:diagnostic imaging; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging*; D003151:Community Health Centers; D006801:Humans; D017410:Practice Guidelines as Topic; D013270:Stomach / Q000000981:diagnostic imaging; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D006113:United Kingdom; D014850:Waiting Lists