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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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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2021-10-29T12:40:14.6829116</datestamp><bib-version>v2</bib-version><id>11846</id><entry>2012-06-28</entry><title>The effects of the Two-Week Rule on NHS colorectal cancer diagnostic services: A systematic literature review</title><swanseaauthors><author><sid>1b1870c5c1ec66eed0bf209e50a6ee25</sid><ORCID>0000-0003-0691-6282</ORCID><firstname>Kym</firstname><surname>Carter</surname><name>Kym Carter</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>bdf5d5f154d339dd92bb25884b7c3652</sid><ORCID>0000-0003-4155-1741</ORCID><firstname>Hayley</firstname><surname>Hutchings</surname><name>Hayley Hutchings</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2012-06-28</date><deptcode>HDAT</deptcode><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.</abstract><type>Journal Article</type><journal>BMC Health Services Research</journal><volume>6</volume><journalNumber>1</journalNumber><paginationStart/><paginationEnd/><publisher>Springer Science and Business Media LLC</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>1472-6963</issnElectronic><keywords/><publishedDay>1</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2006</publishedYear><publishedDate>2006-12-01</publishedDate><doi>10.1186/1472-6963-6-43</doi><url/><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2021-10-29T12:40:14.6829116</lastEdited><Created>2012-06-28T15:41:07.5360833</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Kym</firstname><surname>Carter</surname><orcid>0000-0003-0691-6282</orcid><order>1</order></author><author><firstname>Hayley</firstname><surname>Hutchings</surname><orcid>0000-0003-4155-1741</orcid><order>2</order></author><author><firstname>Glyn</firstname><surname>Elwyn</surname><order>3</order></author></authors><documents><document><filename>0011846-10022015210833.pdf</filename><originalFilename>thornebmchsr.pdf</originalFilename><uploaded>2015-02-10T21:08:33.8470000</uploaded><type>Output</type><contentLength>192750</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><embargoDate>2015-02-10T00:00:00.0000000</embargoDate><documentNotes>Distributed under the terms of a Creative Commons Attribution (CC-BY-2.0)</documentNotes><copyrightCorrect>true</copyrightCorrect></document></documents><OutputDurs/></rfc1807>
spelling 2021-10-29T12:40:14.6829116 v2 11846 2012-06-28 The effects of the Two-Week Rule on NHS colorectal cancer diagnostic services: A systematic literature review 1b1870c5c1ec66eed0bf209e50a6ee25 0000-0003-0691-6282 Kym Carter Kym Carter true false bdf5d5f154d339dd92bb25884b7c3652 0000-0003-4155-1741 Hayley Hutchings Hayley Hutchings true false 2012-06-28 HDAT 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. Journal Article BMC Health Services Research 6 1 Springer Science and Business Media LLC 1472-6963 1 12 2006 2006-12-01 10.1186/1472-6963-6-43 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University 2021-10-29T12:40:14.6829116 2012-06-28T15:41:07.5360833 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Kym Carter 0000-0003-0691-6282 1 Hayley Hutchings 0000-0003-4155-1741 2 Glyn Elwyn 3 0011846-10022015210833.pdf thornebmchsr.pdf 2015-02-10T21:08:33.8470000 Output 192750 application/pdf Version of Record true 2015-02-10T00:00:00.0000000 Distributed under the terms of a Creative Commons Attribution (CC-BY-2.0) true
title The effects of the Two-Week Rule on NHS colorectal cancer diagnostic services: A systematic literature review
spellingShingle The effects of the Two-Week Rule on NHS colorectal cancer diagnostic services: A systematic literature review
Kym Carter
Hayley Hutchings
title_short The effects of the Two-Week Rule on NHS colorectal cancer diagnostic services: A systematic literature review
title_full The effects of the Two-Week Rule on NHS colorectal cancer diagnostic services: A systematic literature review
title_fullStr The effects of the Two-Week Rule on NHS colorectal cancer diagnostic services: A systematic literature review
title_full_unstemmed The effects of the Two-Week Rule on NHS colorectal cancer diagnostic services: A systematic literature review
title_sort The effects of the Two-Week Rule on NHS colorectal cancer diagnostic services: A systematic literature review
author_id_str_mv 1b1870c5c1ec66eed0bf209e50a6ee25
bdf5d5f154d339dd92bb25884b7c3652
author_id_fullname_str_mv 1b1870c5c1ec66eed0bf209e50a6ee25_***_Kym Carter
bdf5d5f154d339dd92bb25884b7c3652_***_Hayley Hutchings
author Kym Carter
Hayley Hutchings
author2 Kym Carter
Hayley Hutchings
Glyn Elwyn
format Journal article
container_title BMC Health Services Research
container_volume 6
container_issue 1
publishDate 2006
institution Swansea University
issn 1472-6963
doi_str_mv 10.1186/1472-6963-6-43
publisher Springer Science and Business Media LLC
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
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description 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.
published_date 2006-12-01T03:13:42Z
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