Objective The 2-week-wait (2ww) referral pathway is used in England to fast-track patients with suspected colorectal cancer (CRC). A two-stage triage pathway was used to prioritise lower gastrointestinal (LGI) endoscopy for suspected CRC during the COVID-19 pandemic. Method All patients referred for an LGI endoscopy via a 2ww referral pathway between March 2020 and July 2020 were assessed. The first stage triaged patients to high, standard or low risk of CRC based on symptoms and faecal immunochemical test (FIT), and offered CT scans to those at high risk. The second stage, endoscopy prioritisation (EP), incorporated the CT results, FIT and symptoms to triage into four groups, EP1–EP4; with EP1 being the most urgent and EP4 the least. The primary outcome measure was CRC detection. Results 514 patients were included. The risk of CRC was triaged as high in 190/514 patients (37%), standard in 274/514 patients (53%) and low in 50/514 (10%) patients. 422/514 patients (82%) underwent endoscopy with triage to EP1 in 52/422 (12%), EP2 in 105/422 (25%), EP3 in 210/422 (50%) and EP4 in 55/422 (13%). CRC was detected in 23 patients (5.4%). CRC was significantly more frequent in the EP1 group (23.1%, relative risk (RR)=16.2) and EP2 group (6.7%, RR=4.7) compared with EP3 group (1.4%). All CRC lesions were identified by CT imaging when performed prior to LGI endoscopy. Conclusion This triage pathway designated 83% of patients with CRC to either EP1 or EP2. During a period of limited endoscopy provision, this pathway effectively prioritises endoscopy for those at greatest risk of CRC. Data are available upon reasonable request. Anonymised data from the study can be requested from the author by emailing thomas.archer@nhs.net.

中文翻译：

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在 COVID-19 大流行期间优先考虑下消化道内窥镜检查：一种新的分流途径的结果

目的 2 周等待 (2ww) 转诊途径在英格兰用于快速跟踪疑似结直肠癌 (CRC) 患者。在 COVID-19 大流行期间，使用两阶段分流途径优先考虑下消化道 (LGI) 内镜检查疑似 CRC。方法 对 2020 年 3 月至 2020 年 7 月期间通过 2ww 转诊途径转诊进行 LGI 内镜检查的所有患者进行评估。第一阶段根据症状和粪便免疫化学测试 (FIT) 将患者分类为 CRC 高风险、标准风险或低风险，并为高风险患者提供 CT 扫描。第二阶段，内窥镜检查优先级 (EP)，将 CT 结果、FIT 和症状分为四组，EP1-EP4；EP1 最紧急，EP4 最不紧急。主要结果测量是CRC检测。结果共纳入514例患者。CRC 的风险在 190/514 名患者 (37%) 中被分类为高，在 274/514 名患者 (53%) 中被分类为标准，在 50/514 (10%) 患者中被分类为低。422/514 名患者 (82%) 接受了内窥镜检查，其中 EP1 在 52/422 (12%)、EP2 在 105/422 (25%)、EP3 在 210/422 (50%) 和 EP4 在 55/422 (13 %）。在 23 名患者 (5.4%) 中检测到 CRC。与 EP3 组 (1.4%) 相比，EP1 组 (23.1%, 相对风险 (RR)=16.2) 和 EP2 组 (6.7%, RR=4.7) 的 CRC 发生率明显更高。在 LGI 内窥镜检查之前进行时，所有 CRC 病变均通过 CT 成像确定。结论 该分流途径将 83% 的 CRC 患者指定为 EP1 或 EP2。在有限的内窥镜检查提供期间，该途径有效地将内窥镜检查优先用于那些最有可能患 CRC 的人。可根据合理要求提供数据。