Call to “liberalise” referral guidelines for bowel cancer

  • Date: 28 May 2014

ONLY half of people diagnosed with bowel cancer present with the "high-risk" symptoms that would qualify for an urgent referral, according to a report from Bowel Cancer UK.

The organisation wants the urgent referral pathway for suspected bowel cancer to be liberalised so that patients with persistent "low-risk" or non-specific symptoms can be assessed. Current national guidelines set out by NICE on referral of urgent suspected bowel cancer are restricted to those with "alarm" or "high-risk" symptoms, such as rectal bleeding.

The report also highlights significant variation in waiting times for diagnostic procedures across the UK. Waiting times in Wales are particularly poor with 15 per cent of patients waiting between eight and 14 weeks and 26 per cent waiting over 14 weeks for a colonoscopy, while in England less than two per cent are waiting more than the recommended six weeks target.

The quality of some services is also of concern. The report authors found many units do not meet best practice standards set out by the Joint Advisory Group (JAG) for Gastroenterology. In England only 48 per cent of NHS units and 15 per cent of private providers are accredited. In Northern Ireland only one out of 17 units is accredited, only two out of the 20 units in Wales and none in Scotland.

Bowel Cancer UK is calling for JAG accreditation to be made mandatory for all units across the UK, including private providers offering NHS services. It also calls for greater investment in endoscopy services to ensure future demand for services is adequately met so that no patients are kept waiting for crucial diagnostic tests.

Deborah Alsina, the charity’s chief executive, said: "We are calling for GP guidelines to be liberalised so that GPs can use their judgement and refer patients even when their symptoms do not point directly to bowel cancer.

"It’s a tragedy that more people are not referred for endoscopy sooner. After all, early diagnosis saves lives."


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