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Updated: May 20, 2026

Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery

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Published on: September 27, 2024

Repeat 2-week wait referrals for colorectal cancer.

P G Vaughan-Shaw¹, J E Cutting, N R Borley

¹Department of Colorectal Surgery, Cheltenham General Hospital, Cheltenham, UK.

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland

|July 11, 2012

Summary

Repeat referrals for suspected colorectal cancer (CRC) are uncommon but not insignificant. Excluding these patients may not reduce workload and risks missing cancers.

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Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction

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Published on: March 24, 2023

Area of Science:

Gastroenterology
Oncology
Health Services Research

Background:

The '2-week wait' pathway for suspected colorectal cancer (CRC2ww) is crucial for timely diagnosis.
Inappropriate use of this pathway may lead to clinic overload and delayed care for other patients.
Patients previously investigated for colorectal cancer may represent a group not requiring repeat urgent referral.

Purpose of the Study:

To determine the incidence of repeat referrals within the CRC2ww pathway.
To assess the diagnostic yield of these repeat referrals.
To evaluate the impact of repeat referrals on healthcare resource utilization.

Main Methods:

Retrospective analysis of all CRC2ww referrals over a 4-year period.
Data extraction from multidisciplinary team, endoscopy, and imaging databases.
Identification of referral indications, outcomes, and repeat referral instances.

Main Results:

A total of 2735 CRC2ww referrals were analyzed, with 122 (4.3%) being repeat referrals.
The incidence of repeat referrals increased from 2% to 6% between 2008 and 2010.
The diagnostic yield for cancer was lower in repeat referrals (5%) compared to initial referrals (10%), though not statistically significant (P=0.07).

Conclusions:

Repeat CRC2ww referrals occur at a low but increasing incidence.
While the diagnostic yield is lower, it remains significant enough to warrant careful consideration.
Excluding patients with previous investigations from urgent assessment may not substantially decrease workload and could potentially delay cancer diagnosis.