{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T01:55:02Z","timestamp":1785376502163,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T00:00:00Z","timestamp":1616976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012095","name":"Scottish Government","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100012095","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The dramatic curtailment of endoscopy and CT colonography capacity during the coronavirus pandemic has adversely impacted timely diagnosis of colorectal cancer (CRC). We describe a rapidly implemented COVID\u2010adapted diagnostic pathway to mitigate risk and maximize cancer diagnosis in patients referred with symptoms of suspected CRC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>The \u2018COVID\u2010adapted pathway\u2019 integrated multiple quantitative faecal immunochemical tests (qFIT) to enrich for significant colorectal disease with judicious use of CT with oral contrast to detect gross pathology. Patients reporting \u2018high\u2010risk\u2019 symptoms were triaged to qFIT+CT and the remainder underwent an initial qFIT to inform subsequent investigation. Demographic and clinical data were prospectively collected. Outcomes comprised cancer detection frequency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 422 patients (median age 64\u00a0years, 220 women) were triaged using this pathway. Most (84.6%) were referred as \u2018urgent suspicious of cancer\u2019. Of the 422 patients, 202 (47.9%) were triaged to CT and qFIT, 211 (50.0%) to qFIT only, eight (1.9%) to outpatient clinic and one to colonoscopy. Fifteen (3.6%) declined investigation and seven (1.7%) were deemed unfit. We detected 13 cancers (3.1%), similar to the mean cancer detection rate from all referrals in 2017\u20132019 (3.3%). Compared with the period 1 April\u201331 May in 2017\u20132019, we observed a 43% reduction in all primary care referrals (1071 referrals expected reducing to 609).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This COVID\u2010adapted pathway mitigated the adverse effects on diagnostic capacity and detected cancer at the expected rate within those referred. However, the overall reduction in the number of referrals was substantial. The described risk\u2010mitigating measures could be a useful adjunct whilst standard diagnostic services remain constrained due to the ongoing pandemic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.15618","type":"journal-article","created":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T01:36:01Z","timestamp":1615167361000},"page":"1639-1648","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Short\u2010term outcomes of a COVID\u2010adapted triage pathway for colorectal cancer detection"],"prefix":"10.1111","volume":"23","author":[{"given":"Janice","family":"Miller","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Western General Hospital Edinburgh UK"},{"name":"Clinical Surgery Royal Infirmary of Edinburgh University of Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4081-4741","authenticated-orcid":false,"given":"Yasuko","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Western General Hospital Edinburgh UK"},{"name":"Clinical Surgery Royal Infirmary of Edinburgh University of Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Au","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Western General Hospital Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Gunn","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Western General Hospital Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorna","family":"Porteous","sequence":"additional","affiliation":[{"name":"Lead GP for Cancer and Palliative Care NHS Lothian Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Pattenden","sequence":"additional","affiliation":[{"name":"Department of Biochemistry Western General Hospital Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"MacLean","sequence":"additional","affiliation":[{"name":"Department of Radiology Western General Hospital Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin L.","family":"Noble","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Western General Hospital Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Glancy","sequence":"additional","affiliation":[{"name":"Department of Radiology Western General Hospital Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm G.","family":"Dunlop","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Western General Hospital Edinburgh UK"},{"name":"Clinical Surgery Royal Infirmary of Edinburgh University of Edinburgh Edinburgh UK"},{"name":"Edinburgh CRUK Cancer Research Centre Edinburgh UK"},{"name":"Institute if Genetics and Molecular Medicine Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5466-8282","authenticated-orcid":false,"given":"Farhat V. N.","family":"Din","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Western General Hospital Edinburgh UK"},{"name":"Clinical Surgery Royal Infirmary of Edinburgh University of Edinburgh Edinburgh UK"},{"name":"Edinburgh CRUK Cancer Research Centre Edinburgh UK"},{"name":"Institute if Genetics and Molecular Medicine Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,29]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.05.009"},{"key":"e_1_2_14_3_1","article-title":"Quantifying and mitigating the impact of the COVID\u201019 pandemic on outcomes in colorectal cancer","author":"Sud A","year":"2020","journal-title":"Gut"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.02.054"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-320891"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.25742"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.02.055"},{"key":"e_1_2_14_8_1","unstructured":"British Society of Gastroenterology.Endoscopy activity and COVID\u201019: BSG and JAG guidance;2020[accessed 16 June 2020]. 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