SP4.2.7 Outcomes following reorganisation of colorectal cancer pathway using FIT testing and a locally developed risk stratification score in a busy District General Hospital in United Kingdom during the COVID-19 pandemic

Abstract

Aims/Introduction Limited availability of endoscopy and CT colonography led to significant pressures on the colorectal cancer pathway during the COVID-19 pandemic. Risk stratification was necessary to determine the order in which patients on the tracking list could access diagnostics. Based on national guidance, patient symptoms and FIT test results, we used a locally developed risk stratification score (RSS). The aim of this study was to evaluate the impact the RSS had on patient diagnoses over a period of 8 months Methodology A prospectively maintained database was used to assess the outcomes. Based on their symptoms, patients on the colorectal 2ww pathway were invited to provide FIT samples if eligible. Diagnostics were prioritised using RSS. Results were analysed to assess how the cancer diagnostic yield during the pandemic compared to a similar period the year before. Results There were 1133 patients referred on the colorectal 2ww pathway between May - December 2020. 884 of these patients had FIT testing and 249 were not eligible. Of the 69 colorectal cancers diagnosed, 25 were in the FIT group and 44 in those not eligible. The RSS stratified to high or indeterminate risk in the non-FIT group was 31 and 23 in the FIT group. Compared to the previous year’s number of 59 patients diagnosed between May - December 2019, no statistical difference was found. Conclusion Our study shows that FIT testing and RSS led to an equivalent pick up rate of colorectal cancer and can be utilised in clinical settings with limited resources.