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The effects of the Two-Week Rule on NHS colorectal cancer diagnostic services: A systematic literature review

Kym Carter Orcid Logo, Hayley Hutchings Orcid Logo, Glyn Elwyn

BMC Health Services Research, Volume: 6, Issue: 1

Swansea University Authors: Kym Carter Orcid Logo, Hayley Hutchings Orcid Logo

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DOI (Published version): 10.1186/1472-6963-6-43

Abstract

BackgroundThe Two-Week Rule (TWR) was introduced to ensure that all patients with a suspected colorectal cancer (CRC) saw a hospital specialist within 14 days of an urgent GP referral. Guidelines were available to GPs to facilitate the appropriate TWR referral of patients exhibiting high-risk CRC sy...

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Published in: BMC Health Services Research
ISSN: 1472-6963
Published: Springer Science and Business Media LLC 2006
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URI: https://cronfa.swan.ac.uk/Record/cronfa11846
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Abstract: BackgroundThe Two-Week Rule (TWR) was introduced to ensure that all patients with a suspected colorectal cancer (CRC) saw a hospital specialist within 14 days of an urgent GP referral. Guidelines were available to GPs to facilitate the appropriate TWR referral of patients exhibiting high-risk CRC symptoms.MethodsWe aimed to evaluate the TWR and its CRC detection rate on NHS CRC diagnostic services by performing a literature search and critically appraising the peer-reviewed studies. Only 12 studies were eligible for inclusion. Data was collected and overall results were given as weighted averages.ResultsThe studies identified indicated that only 10.3% of patients referred by the TWR were eventually diagnosed with CRC. When examining the referral origin of all CRC patients diagnosed during the time of the studies, 24% had been referred using the TWR, 24.1% were referred as emergency cases, and 52.4% were referred using alternative routes. No evidence was found to indicate that the TWR had resulted in identifying CRC patients at an earlier, more treatable stage of their disease.ConclusionThe TWR referral system needs to be improved to increase the number of CRC patients referred using this fast track method as they present to their GP. The TWR and new NICE Guidelines for the referral of patients with suspected cancer should be independently evaluated.
College: Swansea University Medical School
Issue: 1