School of Graduate Entry Medicine and Health, University of Nottingham, UK.
Colorectal Dis. 2013 Aug;15(8):963-7. doi: 10.1111/codi.12220.
The National Bowel Cancer Awareness Campaign ('Be Clear on Cancer') was launched by the UK government in January 2012, encouraging people with bowel symptoms to present to primary care. Our aim was to evaluate the impact of the campaign on colorectal services in secondary care.
Suspected cancer 2-week-wait (2WW) patients 3 months before and 3 months after the launch of the campaign were included. Demographics, reason for referral, investigations performed, cost analysis and eventual diagnoses were collected.
Three hundred and forty-three patients [median age 70 (36-100) years, 194 (57%) women] were seen and investigated in the 3 months prior to the launch of the campaign at an average cost of £575 per patient. Twenty-seven (8%) were diagnosed with lower gastrointestinal cancer and 29 (8%) with polyps. In the 3 months following the launch, 544 patients [median age 68 (30-92) years, 290 (53%) women] were reviewed (59% increase; P = 0.004). The 'did not attend' rate fell from 10% to 1%. Thirty-two (6%) patients were diagnosed with a lower gastrointestinal cancer and 20 (4%) with colorectal polyps. The cost per colorectal cancer detected rose from £7585.58 before the campaign to £9662.72 after launch (P = 0.04).
The 'Be Clear on Cancer' campaign has substantially increased the number of referrals under the 2WW rule, but mainly in the worried well. This has increased demands on both resources (59% more tests) and finance. Cost per cancer detected rose by 27% with no increase in funding to support the increased activity.
英国政府于 2012 年 1 月发起了全国肠癌宣传活动（“明确癌症”），鼓励有肠道症状的人到初级保健就诊。我们的目的是评估该活动对二级保健中结直肠服务的影响。
纳入活动启动前 3 个月和启动后 3 个月的疑似癌症 2 周等待（2WW）患者。收集人口统计学、转诊原因、进行的检查、成本分析和最终诊断。
在活动启动前的 3 个月内，有 343 名患者[中位年龄 70（36-100）岁，194 名（57%）女性]接受了检查和调查，每位患者的平均费用为 575 英镑。27 名（8%）诊断为下消化道癌症，29 名（8%）诊断为息肉。在活动启动后的 3 个月内，有 544 名患者[中位年龄 68（30-92）岁，290 名（53%）女性]接受了复查（增加 59%；P=0.004）。“未出席”率从 10%降至 1%。32 名（6%）患者诊断为下消化道癌症，20 名（4%）患者诊断为结直肠息肉。每例结直肠癌检出的成本从活动前的 7585.58 英镑增加到活动后的 9662.72 英镑（P=0.04）。
“明确癌症”活动大大增加了 2WW 规则下的转诊人数，但主要是在担忧的人群中。这增加了对资源（测试增加 59%）和资金的需求。每例癌症检出的成本增加了 27%，而没有增加资金来支持增加的活动。
