Aung, M.S.; Vuojic, J.; Anwar, S.; Shiwani, M.H.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA89
Academic Journal
Objective: To audit 2 week wait referral (TWR) for suspected upper gastrointestinal malignancy (UGIM) and also to evaluate whether this system identifies patients with suspicion of cancer at early stage of the disease. Method: In a district general hospital all patients referred through TWR desk from September 2000 to December 2001 were studied. All newly diagnosed patients with UGIM referred through the conventional routes in the same period were included. Case notes of all the patients with proven UGIM were studied and data were collected. Result: Of the 307 TWR only 29 (9.4%) patients were diagnosed with UGIM and the majority, 91.6% patients, have alternative diagnosis. Total number of patients diagnosed with UGIM through TWR and conventional routes were 105. Of these 105 UGIM, the majority 76 (72%) patients were referred through conventional routes including A&E: 43(57%), clinic: 20 (26%) and direct access endoscopy: 13 (17%). Median appointment time, referral time to diagnosis, and waiting time to treatment were 12, 21, and 35 days, respectively for TWR group and 25, 34, and 55 days, respectively for conventional group. Staging of the disease and treatment offered was noted using various modalities (see Table). Conclusion: TWR standards are achievable. This system generates more work but does not provide any benefit to diagnose disease at early stage, hence does not have any impact on long term survival.


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