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Abstract Aim Waiting lists on the colorectal 2 week wait (2WW) pathway have grown more than any other tumour group since the pandemic. Faecal Immunochemical Testing (FIT) has a high sensitivity for the detection of colorectal cancer (CRC). A change in the southwest clinical network 2WW referral criteria was made from 2023, with greater emphasis on FIT. This audit examined the impact of this guideline change on referral practices to the colorectal 2WW service and resultant cancer diagnoses. Method A single centre retrospective review of electronic medical records and referral documentation for patients referred to a colorectal 2WW service in 2022 (September-December) prior to guidelines changing, and 2023 (January-April) following guidelines changing, was performed. Referral numbers, use of FIT, endoscopy numbers, and pathologies found were examined and compared between cohorts. Result: Referrals to the 2WW service reduced by more than 50% (837 in 2022 vs. 399 in 2023). A FIT was performed in 374 (44.8%) patients in 2022 and 297 (75.0%) in 2023. There were 560 colonoscopies performed in the first cohort compared to 270 in the 2023 cohort. A CRC was detected in 24 patients in the 2022 cohort compared to 20 patients in the 2023 cohort (p=0.06). Conclusions The introduction of FIT to the 2WW colorectal service has resulted in fewer referrals. This has reduced the requirement for endoscopy with no reduction in diagnosis of colorectal cancer.
O’Connor et al. (Mon,) studied this question.