The impact of the two-week wait rule on the diagnosis and management of bladder cancer in a single UK institution

Ann R Coll Surg Engl. 2010 Jan;92(1):46-50. doi: 10.1308/003588410X12518836440207.


Introduction: The objective of this study was to investigate the impact of the 2-week wait rule on patient waiting times for the diagnosis and treatment of bladder cancer.

Patients and methods: Data reporting the waiting times from diagnosis to treatment for 100 consecutive patients newly diagnosed with bladder cancer immediately before and after the implementation of the 2-week wait rule were compared. The data were collected both prospectively and retrospectively from cancer multidisciplinary team meeting files and patient records. Various steps of the patient pathway were analysed including waiting times from referral to consultation as well as time to investigation and first treatment. Data were also analysed based upon tumour stage/grade and whether referrals were made on an urgent or routine basis.

Results: One hundred newly diagnosed patients with bladder cancer in each group covered a period of 4-5 years (1997-2001 and 2001-2006). Following the introduction of the 2-week wait rule, there was a 47.6% reduction in the time from referral to first consultation with a specialist (42 days vs 22 days; P < 0.001). The time between first investigation and treatment has not reduced significantly. We also found that, despite the introduction of the 2-week wait rule, only 42% of the patients were diagnosed with bladder cancer using this pathway. Patients referred as 'routine' waited longer to be seen in hospital although there was no significant delay in receiving treatment.

Conclusions: The introduction of the 2-week wait rule has significantly reduced the time patients with bladder cancer wait for their first consultation with a specialist. However, there is no significant change in the time between first consultation and treatment.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Hematuria / etiology
  • Humans
  • London
  • Male
  • Middle Aged
  • Prospective Studies
  • Referral and Consultation / statistics & numerical data*
  • Retrospective Studies
  • Time Factors
  • Urinary Bladder Neoplasms / diagnosis*
  • Urinary Bladder Neoplasms / therapy*
  • Waiting Lists*