Has the Two Week Rule Improved Cancer Detection Rates for Gastrointestinal Cancers? A Systematic Literature Review

Abstract

Introduction: The UK government introduced the two-week rule (TWR) to improve the diagnosis and treatment of gastrointestinal (GI) cancers. This updated review systematically identifies new articles since 2009 and presents an overview of the previous and new findings combined for both upper GI cancer (UGCs) and colorectal cancers (CRCs). Methods: We analysed all peer-reviewed articles and conference abstracts with GI cancer detection rates following TWR referral and/or the proportion of TWR-referred GI cancers from the total number diagnosed during the study period. We reported average cancer detection rates and split the data according to four time periods to determine whether TWR effectiveness improved over time. Results: The average cancer detection rate by the TWR for all studies was 11.6% for CRC and 8.3% for UGC. We found a decrease in cancer detection rates over time for CRC from 14.