The 2-week wait referral system does not improve 5-year colorectal cancer survival
Version of Record online: 5 MAR 2012
© 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland
Volume 14, Issue 4, pages e177–e180, April 2012
How to Cite
Zafar, A., Mak, T., Whinnie, S. and Chapman, M. A. S. (2012), The 2-week wait referral system does not improve 5-year colorectal cancer survival. Colorectal Disease, 14: e177–e180. doi: 10.1111/j.1463-1318.2011.02826.x
- Issue online: 5 MAR 2012
- Version of Record online: 5 MAR 2012
- Accepted manuscript online: 15 SEP 2011 12:40PM EST
- Received 8 January 2011; accepted 17 July 2011; Accepted Article Online 15 September 2011
- Colorectal Cancer;
- 2-week wait;
- referral guidelines;
- cancer survival
Aim The aim of this study was to compare 5-year survival rates in colorectal cancer (CRC) patients who underwent potentially curative surgery before and after the introduction of the 2-week wait (2WW) referral system.
Method Data were collected retrospectively from a prospectively maintained cancer database for CRC patients who underwent surgery in 1999 (pre-2WW group, n = 150) and 2002 (post-2WW group, n = 126). Patients who presented as an emergency, those who died within 30 days of surgery and those who presented with incurable CRC were excluded. We used the Kaplan–Meier method to plot survival curves and the log rank test to compare survival rates between the two groups.
Results The 5-year survival rates in the pre-2WW and post-2WW groups did not differ significantly (71%vs 72%, respectively; P = 0.880). The number of CRC patients who presented via urgent pathways was higher in the post-2WW group than in the pre-2WW group (77%vs 38%, P < 0.001). Further, owing to this change in the referral pattern, the overall delay between referral and treatment was significantly lower in the post-2WW group than in the pre-2WW group (median 76 days vs 115, P = 0.009).
Conclusion The 2WW referral system for patients with symptoms of CRC does not translate into improved survival. However, more patients with symptomatic CRC are being referred via urgent pathways.