Practices not using colon cancer referral guidelines

Over half of general practices in England are failing to use the two-week wait referral system to diagnose colorectal cancer, according to UK research.

The two-week wait referral guidelines for colorectal cancer were introduced in July 2000 to help GPs prioritise referral and improve awareness of symptoms.

But the study found that almost a quarter of GPs in England were unaware of the referral guidelines, with only 8 per cent knowing the number of referral criteria.

For the study, the researchers examined a collected database of all colorectal cancers for new cases of the cancer diagnosed in the 12 months from April 2004.

Patients were cross-referenced via GP codes to identify the referral origin.

A postal questionnaire was sent out to all the GPs that had identified the colorectal cancer to assess their method of referral and their knowledge of the two-week guidelines.

A total of 175 patients diagnosed with colorectal cancer were referred from 49 general practices.

Twenty-six practices, 53 per cent, had no colorectal cancer diagnosed via the two-week wait referral guidelines.

While the postal survey revealed that 22 per cent of GPs were unaware of the two-week guidelines.

The researchers, led by Dr Solomon John, from the Royal Bournemouth Hospital in Dorset, said: ‘The postal survey highlights the knowledge and education gap within primary care, in relation to the two-week referral and we can speculate that these factors part explain the variability in referral practice.’

They recommend that GP education is needed to improve implementation of the existing referral guidelines.

Colorectal Disease 2007;9:731-735
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