Colorectal 2WW

It is essential that a patient referral on the RACP pathway is accompanied with the following:

(4F’s)

·         FIT result

·         FBC Result

·         Ferritin result

·         Digital Rectal Examination (DRE)

*Please note, a FIT result is not required for Anal Rectal Mass or Anal Ulceration.

If your patient’s FIT result is negative with no concerning symptoms, we ask you to manage, and safety net the patient in Primary Care. If, however, you remain concerned, please access the advice and guidance via eRS.  The Consultant will review this A&G within 48 hrs and either contact you with information to manage your patient in Primary Care or the Consultant will refer your patient onto a routine/urgent or 2WW pathway. This may include diagnostic tests so please prepare your patient for this. 

Please see below for information on safety netting. Clinical teams should consider:

• Providing the patient with clear information about who to contact if they develop new symptoms or if their existing symptoms worsen

• Consider using advice and guidance via eRS to guide management of patients with persistent or troublesome symptoms

• Consider offering a second FIT test 14 days later if ongoing clinical concerns remain. Results from a recent study show patients with two negative FIT test results have a colorectal cancer risk of <0.04% (1) 

• Consider a referral to a non-specific-symptoms urgent cancer pathway, if appropriate and there are ongoing concerns about possible cancer