Warner, R.J.; Das, D.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA88
Academic Journal
Introduction: The NHS Executive introduced a 2 week standard for cancer referrals in an attempt to speed up diagnosis and improve patient care. This has now been implemented, but are we improving our care because of it, or is it just an additional headache for endoscopy units? Aims: To assess how many referrals: 1) were endoscoped (OGD) within 2 weeks, 2) identified cancer, 3) for upper Gastrointestinal (Gl) cancer came via our cancer office—the Bobby Moore Oncology Unit. Methods: We performed a retrospective audit of apl patients referred via the Bobby Moore unit in a 12 month period. Faxed referrals were made on a standard proforma that was distributed to all local GPs. Data were collected looking at referral information and OGD results. Results: 146 referrals were received (age range 23-92), of which 144 (98.6%) were offered OGD within 2 weeks. 10 patients did not attend 1st appointment. 10/146 (6.8%) had cancer, 6 oesophageal, 2 gastric, 1 pharyngeal and 1 direct spread From transverse colon. Over the same period 61 oesophageal and 43 gastric cancers were identified via alternative routes, ie only 7.7% of upper Gl cancers came on the cancer proforma. Recent onset dyspepsia in patients > 45 years as the only symptom (28/146) yielded 0 cancers, whereas 11% of patients with dysphagia had cancer. Conclusions: We only detected 7.7% of upper Gl cancers via our cancer proforma. Patients who did not attend in our study did not have cancer on subsequent OGD. Dyspepsia alone did not yield any cancers. Although offering this rapid access service we may be delaying OGDs for patients with cancer referred from other sources.


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