The effectiveness of the colorectal cancer referral pathway–identification of colorectal cancer in a Swedish region

Abstract

Introduction: To shorten the time for diagnosis of suspected colorectal cancer (CRC), a standardized colorectal cancer referral pathway (CCRP) was introduced in Sweden in September 2016. However, the effects of the CCRP are still uncertain, and CRC is also found in patients undergoing a routine colonoscopy. Objective: To identify all CRC-cases in the Region Örebro County and to investigate via which diagnostic pathway they were diagnosed. Furthermore, to investigate the reasons for and possible effect of not being included in the CCRP for cases found via colonoscopy. Methods: Review of medical records of patients with CRC referred to the department of surgery in the Region Örebro County in 2016–2018 (n = 459). Results: In CRC-cases found through colonoscopy (n = 347), 37.5% were diagnosed via a routine waiting list and 62.5% within the CCRP. No difference in tumor stage or tumor grade was found between the two groups. The non-CCRP showed a longer time to diagnosis than the CCRP group (21.5 days, IQR 7–43 vs. 13 days, IQR 8–17 (p