{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T19:54:58Z","timestamp":1791316498826,"version":"4.3.1"},"reference-count":14,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2015,10,9]],"date-time":"2015-10-09T00:00:00Z","timestamp":1444348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The 2\u2010week wait pathway was designed to decrease the time from presentation to primary care of patients with \u2018red flag\u2019 symptoms of suspected cancer for review by a specialist for the diagnosis or exclusion of cancer. In our tertiary referral centre we have found that 968 colonoscopies per year are required to satisfy the demand for the 2\u2010week wait, leading to limited colonoscopy availability for other services. We sought to determine the yield of colorectal cancer found at colonoscopy referred via the 2\u2010week wait and referenced to the original red flag symptoms. This was in order to select the most efficacious alternative primary investigation based upon presenting symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Electronic records were retrospectively analysed. All patients who went through the 2\u2010week wait for suspicion of colorectal cancer in 2013 and were found to have colorectal cancer on colonoscopy were included. Patients not undergoing colonoscopy as the first investigation were excluded. The splenic flexure was deemed to be within the range of a flexible sigmoidoscope.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 2950 referrals were made. 968 colonoscopies were performed as the primary investigation of which 35 were found to have colorectal cancer. No patients referred with rectal bleeding and another symptom had a tumour more proximal to the range of flexible sigmoidoscopy. 80% of tumours proximal to the splenic flexure were suitable for <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> diagnosis alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data support the use of flexible sigmoidoscopy alone as an initial investigation for patients presenting with rectal bleeding with or without additional colorectal symptoms. Patients with anaemia (without bleeding) or change in bowel habit (without bleeding) may be investigated with <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> colonography alone; colonoscopy may then be used selectively prior to surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12988","type":"journal-article","created":{"date-parts":[[2015,5,6]],"date-time":"2015-05-06T07:43:03Z","timestamp":1430898183000},"page":"980-983","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Straight to flexible sigmoidoscopy: rationalization of 2\u2010week wait referrals in suspected colorectal cancer"],"prefix":"10.1111","volume":"17","author":[{"given":"D. G.","family":"Couch","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Leicester Royal Infirmary Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. H.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Derby Royal Hospital Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. M.","family":"Boyle","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Leicester Royal Infirmary Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. M.","family":"Hemingway","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Leicester Royal Infirmary Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,10,9]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Referral Guidelines for Suspected Cancer.National Institute for Health and Care Excellence Clinical Guideline 27 June 2005. Available atwww.nice.org.uk\/guidance\/CG27(accessed 16 October 2014)."},{"key":"e_1_2_9_3_1","unstructured":"The Diagnosis and Management of Colorectal Cancer. National Institute for Health and Care Excellence NICE Guideline 131 November 2011. Available atguidance.nice.org.uk\/cg131(accessed 16 October 2014)."},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2006.01107.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2005.00935.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2010.02505.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-6-43"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12508"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6234"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2011.02918.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2009.01.008"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)62186-2"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa070543"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2392051101"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2014.01.007"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcodi.12988","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.12988","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T19:11:15Z","timestamp":1696360275000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.12988"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,10,9]]},"references-count":14,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2015,11]]}},"alternative-id":["10.1111\/codi.12988"],"URL":"https:\/\/doi.org\/10.1111\/codi.12988","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,10,9]]},"assertion":[{"value":"2014-11-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-03-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-10-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}