Impact of the United Kingdom National Bowel Cancer Awareness Campaign on Colorectal Services

Abstract

Poor public awareness may account for the advanced stage at diagnosis, hence, poorer survival. With the aim of reducing colorectal cancer deaths, the United Kingdom National Bowel Cancer Awareness Campaign was rolled out from January 2012. Currently, the United Kingdom government target is to have all patients suspected to have cancer seen within 2 weeks of referral from general practitioners. This has significant impact on the workload for endoscopists. The study aimed to measure the impact on colorectal services following the National Bowel Cancer Awareness Campaign. The data between February and July 2012 (onset of campaign) were prospectively collected and compared with data retrospectively collected between February and July 2011 inclusive (before campaign). This study was conducted at a single center, university hospital. The number of 2-week wait referrals, investigations, and colorectal cancers detected were assessed. Demographics, staging, and treatment of cancers were compared between groups along with the uptake of colorectal cancer screening. The total number of 2-week wait referrals increased by 47% with a resultant 38% increase in colonic investigations (p = 0.034) and a 23% increase in cancers detected (p = 0.0157). There was a 6.5% increase in the uptake of screening (p = 0.001) and a 62.5% decrease in the number of patients with colorectal cancer presenting as an emergency. This short period of study is a major limitation. Although the data were from prospectively maintained databases, some data were analyzed retrospectively. Because only a single unit was assessed, results across a wider population may be more pronounced. There was also a referral bias in the compliance of primary care in the adherence to the 2-week wait referral criteria, because these criteria can be abused to get anxious patients into secondary care quickly. The National Bowel Cancer Awareness Campaign significantly increased the demand for colorectal services. With a potentially more favorable oncological outcome, further evaluation of supporting this greater workload demand is warranted.