A district general hospital experience of the rapid access referral for colorectal cancers

Aims: Critics doubted the efficacy of the guidelines for referral to 2-week rapid access colorectal cancer (CRC) clinic that was introduced by the Department of Health of England and Wales in August 2000. We aimed to assess the usefulness of the guidelines in a district general hospital over a period of three years.

Methods: All valid referrals to the rapid access colorectal cancer clinics of Bishop Auckland General and Darlington Memorial Hospitals between August 2000 and July 2003 were studied. Details were obtained retrospectively from case notes aided by electronic records.

Results: A total of 929 referrals were studied. Some 89 CRC were diagnosed. Colorectal cancer detection rate was significantly higher when guidelines were complied with (n=80; 12% of 663) than noncompliant referrals (n=9; 3.4% of 266) [Pearson Chi-Square=16.5; p<0.0001]

Guidelines followed	Colorectal cancer	Other (non-cancer)	Total
No	9	257	266
Yes	80	583	663

Conclusions: Association between CRC detection rate and compliance to the guidelines was statistically significant. This should dispel any doubt about the efficacy of the guidelines, which should be adhered to, while urgently referring patients with suspected CRC.