The 2-week wait for suspected cancer: time for a rethink?

The 2-week rule, stating that patients with suspected cancer should be seen by a specialist within 2 weeks of referral by their General Practitioner, was introduced in the UK in 2000. Although it has been the subject of much interest in the literature, to date there has been no review of the literature. A thorough literature review was undertaken using the medline database, from January 2000; further references were obtained from the reference lists of relevant papers. Some studies have demonstrated a reduction in the waiting times to see specialists, and in some cases time to treatment, and have commented on the potential psychological benefits to patients. However, concerns have been raised over the often low yield of malignancy and the high proportion of malignancies still being diagnosed outside the 2-week wait system. There is, as yet, no evidence that the initiative impacts on survival.