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Has the breast cancer 'two week wait' guarantee for assessment made any difference?
1Eastbourne District General Hospital, Eastbourne, BN21 2UD, UK.
Summary
The implementation of the two-week wait referral system for breast cancer led to a decrease in cancer detection rates and longer waiting times for non-urgent cases, suggesting specialist control over referrals is crucial.
Area of Science:
- Oncology
- Health Services Research
Background:
- The 'two week wait' (TWW) initiative aimed to expedite breast cancer diagnosis.
- General Practitioners (GPs) manage initial patient referrals to specialist clinics.
Purpose of the Study:
- To evaluate GP referral practices to a Fast Access Breast Clinic (FABC) before and after TWW implementation.
- To assess the TWW's impact on breast cancer detection rates and clinic access.
Main Methods:
- A complete audit cycle was conducted at a District General Hospital.
- Key outcome measures included detected breast cancer, GP referral accuracy, and FABC waiting times.
Main Results:
- Pre-TWW: 22% cancer detection, 1-week wait for cancers, 4-week routine wait, 42% GP accuracy.
- Post-TWW: 19% cancer detection, 85% seen within 2 weeks, 8-week routine wait, 49% GP accuracy.
Conclusions:
- Transferring referral urgency decisions to GPs decreased cancer detection and increased routine waiting times.
- Specialist control over FABC referrals is recommended to meet TWW targets and optimize patient care.