Department of Colorectal Surgery, University Hospitals of Coventry and Warwickshire, Coventry, United Kingdom.
Dis Colon Rectum. 2014 Jan;57(1):70-5. doi: 10.1097/01.dcr.0000437689.19579.97.
Poor public awareness may account for the advanced stage at diagnosis, hence, poorer survival. With the aim of reducing colorectal cancer deaths, the United Kingdom National Bowel Cancer Awareness Campaign was rolled out from January 2012. Currently, the United Kingdom government target is to have all patients suspected to have cancer seen within 2 weeks of referral from general practitioners. This has significant impact on the workload for endoscopists.
The study aimed to measure the impact on colorectal services following the National Bowel Cancer Awareness Campaign.
The data between February and July 2012 (onset of campaign) were prospectively collected and compared with data retrospectively collected between February and July 2011 inclusive (before campaign).
This study was conducted at a single center, university hospital.
The number of 2-week wait referrals, investigations, and colorectal cancers detected were assessed.
Demographics, staging, and treatment of cancers were compared between groups along with the uptake of colorectal cancer screening.
The total number of 2-week wait referrals increased by 47% with a resultant 38% increase in colonic investigations (p = 0.034) and a 23% increase in cancers detected (p = 0.0157). There was a 6.5% increase in the uptake of screening (p = 0.001) and a 62.5% decrease in the number of patients with colorectal cancer presenting as an emergency.
This short period of study is a major limitation. Although the data were from prospectively maintained databases, some data were analyzed retrospectively. Because only a single unit was assessed, results across a wider population may be more pronounced. There was also a referral bias in the compliance of primary care in the adherence to the 2-week wait referral criteria, because these criteria can be abused to get anxious patients into secondary care quickly.
The National Bowel Cancer Awareness Campaign significantly increased the demand for colorectal services. With a potentially more favorable oncological outcome, further evaluation of supporting this greater workload demand is warranted.
公众意识较差可能导致诊断时已处于晚期，因此生存机会较差。为了降低结直肠癌死亡率，英国国家结直肠癌宣传活动于 2012 年 1 月启动。目前，英国政府的目标是让所有疑似癌症的患者在从全科医生转诊后的 2 周内得到诊治。这对内镜医生的工作量有重大影响。
研究旨在评估全国结直肠癌宣传活动对结直肠服务的影响。
2012 年 2 月至 7 月（活动开始）期间的数据进行了前瞻性收集，并与 2011 年 2 月至 7 月（活动前）期间的数据进行了回顾性比较。
本研究在一家单中心大学医院进行。
评估了 2 周内就诊的转诊人数、检查和结直肠癌的检出情况。
对两组患者的人口统计学、分期和治疗情况进行比较，并评估结直肠癌筛查的接受情况。
2 周内就诊的转诊人数增加了 47%，结肠检查增加了 38%（p = 0.034），癌症检出率增加了 23%（p = 0.0157）。筛查的接受率增加了 6.5%（p = 0.001），急症就诊的结直肠癌患者数量减少了 62.5%。
本研究的时间跨度较短，这是一个主要限制。尽管数据来自于前瞻性维护的数据库，但有些数据是回顾性分析的。由于只评估了一个单位，因此更广泛人群的结果可能更为显著。初级保健机构在遵守 2 周就诊转诊标准方面也存在转诊偏见，因为这些标准可能被滥用，以便将焦虑的患者尽快转至二级保健机构。
全国结直肠癌宣传活动显著增加了结直肠服务的需求。鉴于可能有更有利的肿瘤学结果，有必要进一步评估是否支持这一更大的工作量需求。
