BMJ  2003;327:263-265 (2 August), doi:10.1136/bmj.327.7409.263

Primary care

Identifying and managing patients at low risk of bowel cancer in general practice

¹ Department of Surgery, Queen Alexandra Hospital, Portsmouth PO6 3LY, ² School of Postgraduate Medicine, Queen Alexandra Hospital, ³ Kaversham Group Practice, London, ⁴ New Cross Hospital, Wolverhampton, ⁵ Bowel Cancer Campaign, Twickenham TW1 1QS, ⁶ Colorectal Cancer Unit, St Mark's Hospital, Harrow, Middlesex

The first 150 words of the full text of this article appear below.

Introduction

All NHS patients who are suspected to have bowel cancer by their general practitioner should now be seen by a specialist within two weeks. The government introduced this policy in July 2000 in response to concerns that some patients had to wait too long for an outpatient appointment. However, this new policy could distort referral patterns either by increasing the referral of patients with transient symptoms or by increasing the delay for cancer patients presenting with non-typical symptoms. Unless general practitioners act as efficient gatekeepers, specialist services could become overloaded. We explain the basis for the government's guidelines for referral and discuss how to manage patients at low risk of cancer.

Development of guidelines for referral

The Department of Health has developed guidelines to help general practitioners decide which patients require fast track referral and which can safely be treated and monitored in general practice (table).^{1 2}

View this table: [in this window] [in a new window]   Department of Health criteria for high and . . . [Full text of this article]

 

Why is selection needed?

Selecting patients for referral

Watching and waiting

Discussion

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