Potential for Reducing Time to Referral for Colorectal Cancer Patients in Primary Care

Optimising the diagnostic process in primary care is crucial to help reduce cancer-related disease burden. This retrospective cohort study from the Netherlands aimed to explore reasons for delay in referral for colorectal cancer patients in primary care. According to the findings, those at risk for longer time to referral were female patients, those without a registered family history, those who had a history of malignancy, patients that lacked alarm symptoms at presentation, or patients with hemorrhoids at physical examination. The main themes associated with longest times to referral included “alternative working diagnosis”, and “suboptimal diagnostic strategies”, as well as the sub-themes “omitting to reconsider an initial diagnosis” and “lacking follow-up.” These findings suggest long time to referral for colorectal cancer in primary care is mainly related to low cancer suspicion. Earlier reconsideration of the initial hypothesis, and implementation of strict follow-up consultations have the potential to reduce these delays.

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