Academic Unit of Medical and Surgical Gastroenterology, Homerton University Hospital NHS Foundation Trust, Homerton Hospital, London, UK.
Colorectal Dis. 2010 Oct;12(10 Online):e250-4. doi: 10.1111/j.1463-1318.2009.02182.x.
This study aimed to determine whether a 'straight to test'(STT) strategy for 2-week wait (2 wk) referrals for suspected colorectal cancer (CRC) reduced the time to diagnosis and treatment for patients with CRC.
Consecutive 2-week referrals for suspected CRC over a period of 2 years from February 2007 were analysed. The times to the first diagnostic test and treatment and the cancers identified were analysed for those going to STT or the outpatient clinic.
Of 662 patients having a 2 wk referral, 519 (78.4%) were suitable for the hospital colorectal telephone triage service, 121 (18.3%) patients went to STT and 502 (75.8%) were seen in the clinic. Of these 401 (79.8%) underwent diagnostic tests and 25 (6.2%) had CRC and in 12 (2.9%) patients other cancers were detected. In the STT group, 7 (5.8%) patients were diagnosed with CRC. The median time to first diagnostic test was 12 days (IQR 9-13) in the STT pathway, compared with 23 days (17-31) in those seen in the clinic (P < 0.0001). The median time to first treatment was 40 (32-48) days for those via STT, compared to 46 (28-55) days for those seen in the clinic (P = 0.004). A total of 162 CRC were diagnosed during the study period of whom 34 (20.9%) were 2 wk referrals (5.1% of all suspected CRC 2 wk referrals), and 14 (2.1%) other cancers were detected via this pathway.
STT speeds up the patient pathway by reducing the time to diagnosis and treatment for patients with CRC.
本研究旨在确定对于疑似结直肠癌（CRC）的 2 周等待（2 wk）转诊患者，采用“直接检测（STT）”策略是否能缩短 CRC 患者的诊断和治疗时间。
分析了 2007 年 2 月期间连续 2 年的疑似 CRC 2 wk 转诊患者。分析了采用 STT 或门诊就诊的患者首次诊断性检查和治疗的时间以及检出的癌症情况。
在 662 例 2 wk 转诊患者中，519 例（78.4%）适合医院结直肠电话分诊服务，121 例（18.3%）患者采用 STT，502 例（75.8%）在门诊就诊。这些患者中有 401 例（79.8%）接受了诊断性检查，25 例（6.2%）患有 CRC，12 例（2.9%）患者检出其他癌症。在 STT 组中，有 7 例（5.8%）患者诊断为 CRC。STT 组首次诊断性检查的中位时间为 12 天（9-13 天），而门诊就诊组为 23 天（17-31 天）（P<0.0001）。STT 组首次治疗的中位时间为 40 天（32-48 天），而门诊就诊组为 46 天（28-55 天）（P=0.004）。在研究期间共诊断出 162 例 CRC，其中 34 例（20.9%）为 2 wk 转诊（所有疑似 CRC 2 wk 转诊的 5.1%），通过该途径还检出 14 例（2.1%）其他癌症。
STT 通过缩短 CRC 患者的诊断和治疗时间，加快了患者的就诊流程。
