Optimizing Urgent Suspected Colon Cancer Referrals and Reducing Colonoscopy Wait Times in Wales.

IF 1 Q3 MEDICINE, GENERAL & INTERNAL
Cureus Pub Date : 2024-12-29 eCollection Date: 2024-12-01 DOI:10.7759/cureus.76597
Atreya Subramanian, Ashwin Nair, Parinita Swarnkar, Keshav Swarnkar
{"title":"Optimizing Urgent Suspected Colon Cancer Referrals and Reducing Colonoscopy Wait Times in Wales.","authors":"Atreya Subramanian, Ashwin Nair, Parinita Swarnkar, Keshav Swarnkar","doi":"10.7759/cureus.76597","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To assess recent colonoscopies and CT scans in conjunction with the feacal immunochemical test (FIT) for possibly downgrading urgent suspected cancer (USC) referrals.</p><p><strong>Methods: </strong> A retrospective single-centre study was conducted, including all USC referrals for colonoscopy in 2022, excluding anal cancers. The CT and colonoscopy findings for a two-year period prior to the referral, along with the FIT result (if done), were noted. Combinations of tests were used to ascertain if any such combination would predict a negative colonoscopy (no cancer detected).</p><p><strong>Results: </strong> Out of 500 USC referrals made, 160 were positive for colorectal cancer (CRC). Twelve cases had prior negative CT scans and colonoscopies, and none showed cancer (three were FIT and nine FIT not performed). A total of 54 cases had a prior CT with no FIT, four of which showed cancer. Fifteen cases had a prior CT with a negative FIT, and none showed cancer. Sixteen cases had prior negative colonoscopies, and all were negative for cancer (five negative FIT, one positive FIT, and 10 FIT not done ). Combining the categories where no cancer was missed, potentially 40 referrals could have been downgraded safely (8%).</p><p><strong>Conclusions: </strong> The above data indicate that, among the patients being considered for a colorectal USC referral, a combined prior negative colonoscopy and CT scan warrants a downgrading of the referral (irrespective of the FIT result). Referrals with a prior negative CT (abdomen) with a negative FIT or normal colonoscopy within the last two years can be safely downgraded. This will have a positive impact on waiting times and monetary expenditure on the USC pathway, but larger studies would be required to prove the external validity of these findings.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"16 12","pages":"e76597"},"PeriodicalIF":1.0000,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683376/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cureus","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.7759/cureus.76597","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Aim: To assess recent colonoscopies and CT scans in conjunction with the feacal immunochemical test (FIT) for possibly downgrading urgent suspected cancer (USC) referrals.

Methods:  A retrospective single-centre study was conducted, including all USC referrals for colonoscopy in 2022, excluding anal cancers. The CT and colonoscopy findings for a two-year period prior to the referral, along with the FIT result (if done), were noted. Combinations of tests were used to ascertain if any such combination would predict a negative colonoscopy (no cancer detected).

Results:  Out of 500 USC referrals made, 160 were positive for colorectal cancer (CRC). Twelve cases had prior negative CT scans and colonoscopies, and none showed cancer (three were FIT and nine FIT not performed). A total of 54 cases had a prior CT with no FIT, four of which showed cancer. Fifteen cases had a prior CT with a negative FIT, and none showed cancer. Sixteen cases had prior negative colonoscopies, and all were negative for cancer (five negative FIT, one positive FIT, and 10 FIT not done ). Combining the categories where no cancer was missed, potentially 40 referrals could have been downgraded safely (8%).

Conclusions:  The above data indicate that, among the patients being considered for a colorectal USC referral, a combined prior negative colonoscopy and CT scan warrants a downgrading of the referral (irrespective of the FIT result). Referrals with a prior negative CT (abdomen) with a negative FIT or normal colonoscopy within the last two years can be safely downgraded. This will have a positive impact on waiting times and monetary expenditure on the USC pathway, but larger studies would be required to prove the external validity of these findings.

优化紧急疑似结肠癌转诊和减少结肠镜检查等待时间在威尔士。
目的:评估近期结肠镜检查和CT扫描结合粪便免疫化学试验(FIT)可能降低紧急疑似癌症(USC)转诊。方法:进行了一项回顾性单中心研究,包括2022年所有南加州大学转诊的结肠镜检查,不包括肛门癌。记录转诊前两年的CT和结肠镜检查结果,以及FIT结果(如果完成)。使用组合测试来确定是否有任何此类组合可以预测结肠镜检查阴性(未检测到癌症)。结果:在500名USC转诊患者中,160名结直肠癌(CRC)阳性。12例患者既往CT扫描和结肠镜检查均为阴性,未发现癌症(3例FIT, 9例未进行FIT)。共有54例患者既往CT未见FIT,其中4例显示癌症。15例既往CT显示FIT阴性,无肿瘤。16例既往结肠镜检查阴性,所有患者均为癌症阴性(5例FIT阴性,1例FIT阳性,10例FIT未完成)。结合没有遗漏癌症的类别,可能有40个转诊可以安全地降级(8%)。结论:上述数据表明,在考虑转诊结肠直肠USC的患者中,既往结肠镜检查和CT扫描均阴性的患者应降级转诊(无论FIT结果如何)。既往CT(腹部)阴性且FIT阴性或结肠镜检查在过去两年内正常的转诊可安全降级。这将对USC途径的等待时间和货币支出产生积极影响,但需要更大规模的研究来证明这些发现的外部有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信