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PTH-300 The “two-week wait” referral pathway is not associated with improved overall survivals for patients with colorectal cancer
  1. MI Aslam,
  2. B Singh,
  3. S Chaudhri,
  4. JS Jameson
  5. Leicester Specialist Colorectal Advisory Group
  1. Department of Colorectal Surgery, University Hospitals of Leicester NHS Trust, Leicester, UK


Introduction Two-Week Wait (2WW) referral pathways including referral to treatment targets in NHS were introduced to shorten delays in the diagnosis and treatment of colorectal cancer (CRC), and to improve overall survivals. This study aimed to analyse overall survivals for patients diagnosed with CRC and compare these for mode of referral and referral to treatment times.

Method A prospectively maintained database of colorectal cancer outcomes (2004–2013) at University Hospitals of Leicester NHS Trust was analysed. Data for patients diagnosed with CRC was analysed for survival comparisons. Comparisons were made for mode of referral (2WW, Urgent, Routine, Emergency, National Bowel Cancer Screening and other screening pathway) and referral to initial treatment times (<62 days group vs. >62 days group). Inter-group and intra-group comparisons were made with Mann-Whitney-U-test. Kaplan-Meier survival probability estimates were calculated for overall survival and log-rank test was used to compare the survival distributions in different groups.

Results Overall survivals (median time) were significantly (p < 0.001) lower for patients referred on ‘2ww’ pathway (3.5 years, 95% CI: 2.7–4.30), in comparison to ‘Routine’ (5.4 years, 95% CI: 4.5–6.6) pathway. Patients referred on 2ww pathway were 1.34 times more likely to have stage IV disease on presentation in comparison to patients referred on routine pathway. For referral to initial treatment times, there was no significant difference in survivals between <62 days group and >62 days group (7.1 vs. 6.54, p = 0.620).

Conclusion CRCs detected on 2ww pathway were associated with lower survivals even though these patients were started on their treatment earlier compared to patients referred on regular pathway.

Disclosure of interest None Declared.

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