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OALib Journal期刊
ISSN: 2333-9721
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Referring Patients with Iron Deficiency Anaemia to Colorectal Surgery under the Two-Week Wait Rule

DOI: 10.4236/oalib.1106169, PP. 1-6

Subject Areas: Clinical Medicine, Translational Medicine, Gastroenterology & Hepatology

Keywords: Iron Deficiency Anaemia, Colorectal Cancer, 2 Weeks Wait Referral

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Abstract

Asymptomatic colonic and gastric carcinoma may present with IDA (Iron deficiency anaemia), and seeking these conditions is a priority in patients with IDA. One of the criteria under the Two-Week Referral (TWR) rule for suspected GI malignancy is iron deficiency anaemia (IDA). Although IDA is a good marker for gastrointestinal cancer, sometimes 2WW referral guidelines are not being followed appropriately for IDA. This not only has considerable workload and financial implications but also invasive investigations could lead to unnecessary adverse risks. Our aim was to find the proportion of patients referred as a 2WW for IDA not meeting the criteria, and the cost accrued by unnecessary referral. Also, to find out the cancer pick up rate in the patients who were referred appropriately according to the guideline and who were referred in appropriately without following the guidelines, Retrospective data collected. Consecutive 60 patients referred over 1 month from 9/07/2019 till 8/08/2019 as IDA were identified using the hospitals cancer database. The male and female patients were almost equal. Minimum age was 33 years and maximum age was 94 years. 3 patients were excluded due to incomplete data. Among 57 patients 42 were referred as true IDA whereas 15 (26%) were referred without having true IDA. They underwent colonoscopy and OGD. 5 patients were diagnosed with different cancers. All of them were in true IDA group. Cancer pick up rate in false IDA group was 0%. Finally, it can be said that the inappropriate referral has no advantage in cancer picking up rather increasing unnecessary health expenditure. Thus, the referring guidelines should be followed to decrease the unnecessary cost.

Cite this paper

Miah, M. , Begum, H. , Currie, F. , Wild, T. and Saramigy, M. A. (2020). Referring Patients with Iron Deficiency Anaemia to Colorectal Surgery under the Two-Week Wait Rule. Open Access Library Journal, 7, e6169. doi: http://dx.doi.org/10.4236/oalib.1106169.

References

[1]  Goddard, A.F., James, M.W., McIntyre, A.S. and Scott, B.B. (2011) Guidelines for the Management of Iron Deficiency Anaemia. Gut, 60, 1309-1316. https://doi.org/10.1136/gut.2010.228874
[2]  National Institute for Health and Care Excellence (2015) Suspected Cancer: Recognition and Referral. London: NICE.

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