Reduction in the Proportion of Patients With Colorectal Cancer Presenting as an Emergency Following the Introduction of Fast-Track Flexible Sigmoidoscopy: A Three-Year Prospective Observational Study

Colorectal Dis. 2004 Jul;6(4):265-7. doi: 10.1111/j.1463-1318.2004.00598.x.


Objective: We established a fast-track flexible sigmoidoscopy service to meet the two-week target for colorectal cancer, and have performed a prospective observational study over three years to assess its impact on the proportion of patients with colorectal cancer presenting as an emergency.

Methods: The fast-track system was established on 1 November 1999 using six screening criteria to select high-risk patients. Data on all high-risk patients referred through the fast-track system and all patients diagnosed with colorectal cancer were recorded prospectively in two time periods: six months before fast-track (1 November 1998 to 30 April 1999, Period 1) and three years following fast-track (1 November 1999 to 31 October 2002, Period 2).

Results: In Period 2, 2294 fast-track referrals were received. A total of 635 cases (321 male, 314 female) of colorectal cancer were diagnosed in Period 2 vs. 84 cases (43 male, 41 female) in Period 1. In Period 1, 30 patients with colorectal cancer (35.7% of the total) presented as an emergency vs. 165 patients (25.9%) in Period 2 (P = 0.059, chi(2)test).

Conclusion: Introduction of a fast-track service to meet the two-week target has resulted in a trend towards fewer emergency presentations with colorectal cancer.

MeSH terms

  • Appointments and Schedules*
  • Colorectal Neoplasms / diagnosis*
  • Emergencies
  • Female
  • Hospitals, General / statistics & numerical data
  • Humans
  • Male
  • Patient Admission / statistics & numerical data
  • Prospective Studies
  • Referral and Consultation / statistics & numerical data
  • Sigmoidoscopy / methods*
  • Time Factors
  • United Kingdom / epidemiology