Short‐term outcomes of a COVID‐adapted triage pathway for colorectal cancer detection
| العنوان: | Short‐term outcomes of a COVID‐adapted triage pathway for colorectal cancer detection |
|---|---|
| المؤلفون: | P MacLean, Janice Miller, Rebecca J Pattenden, Malcolm G. Dunlop, S Glancy, Colin L. Noble, Farhat V N Din, Yasuko Maeda, Stephanie Au, Lorna Porteous, Frances Gunn |
| المصدر: | Miller, J, Maeda, Y, Au, S, Gunn, F, Porteous, L, Pattenden, R, Maclean, P, Noble, C L, Glancy, S, Dunlop, M G & Din, F V N 2021, ' Short-term outcomes of a COVID-adapted triage pathway for colorectal cancer detection ', Colorectal Disease . https://doi.org/10.1111/codi.15618Test Colorectal Disease |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Colorectal cancer, Colonoscopy, colorectal cancer, Gross examination, 03 medical and health sciences, 0302 clinical medicine, COVID‐19, Internal medicine, medicine, Humans, Outpatient clinic, Adverse effect, Aged, medicine.diagnostic_test, SARS-CoV-2, business.industry, Gastroenterology, COVID-19, Cancer, Original Articles, Middle Aged, medicine.disease, Triage, qFIT, Endoscopy, Occult Blood, 030220 oncology & carcinogenesis, Female, Original Article, 030211 gastroenterology & hepatology, Colorectal Neoplasms, business, faecal immunochemical tests |
| الوصف: | AimThe dramatic curtailment of endoscopy and CT colonography capacity during the coronavirus pandemic has adversely impacted timely diagnosis of colorectal cancer (CRC). We describe a COVID-adapted diagnostic pathway, rapidly implemented, to mitigate risk and maximise cancer diagnosis in patients referred with symptoms of suspected CRC.MethodsThe “COVID-adapted pathway” 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 ‘high-risk’ symptoms were triaged to qFIT+CT and the remainder underwent an initial qFIT to inform subsequent investigation. Demographic and clinical data was prospectively collected. Outcomes comprised cancer detection frequency. ResultsOverall 422 patients (median age 64 years, 220 females) were triaged using this pathway. Most (84·6%) were referred as ‘urgent suspicious of cancer’. 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 2017-2019 (3·3%). Compared to 1st April – 31st May in 2017-2019, we observed a 43% reduction in all primary care referrals (1071 referrals expected reducing to 609).ConclusionThis COVID-adapted pathway mitigated the adverse effects of diagnostic capacity and detected the expected cancer rate within those referred. However, the overall reduction in number of referrals was substantial. The described risk mitigating measures could be a useful adjunct whilst standard diagnostic services remain constrained due to the ongoing pandemic. |
| وصف الملف: | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| اللغة: | English |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b70fc29a2970d88996a737c718a619f0Test https://www.pure.ed.ac.uk/ws/files/199044527/Short_term_outcomes_of_a_COVID_adapted_triage_pathway_for_colorectal_cancer_detection_AAM.docxTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....b70fc29a2970d88996a737c718a619f0 |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |