To the Editor: Despite the availability of clinical guidelines,1 management of patients with colorectal cancer is variable.2 The lack of a clear referral pathway can delay this journey3 and result in patients not receiving optimal care.4 To increase our understanding of factors influencing the referral of patients with colorectal cancer from general practice to specialists, we examined the views of 19 general practitioners in four focus groups — held in rural and urban New South Wales, rural Queensland, and urban South Australia.
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- 1. Australian Cancer Network. Clinical practice guidelines for the prevention, early detection and management of colorectal cancer. Canberra: NHMRC, 2005.
- 2. Barrett J, Jiwa M, Rose P, Hamilton W. Pathways to the diagnosis of colorectal cancer: an observational study in three UK cities. Fam Pract 2006; 23: 15-19.
- 3. Scott MA, Knight A, Brown K, Novell JR. A single common urgent pathway for all colorectal referrals reduces time to diagnosis and treatment. Colorectal Dis 2006; 8: 766-771.
- 4. Spigelman AD. People with colorectal cancer: can we help them do better? ANZ J Surg 2004; 74: 401-402.
- 5. Archampong D, Borowski DW, Dickinson HO. Impact of surgeon volume on outcomes of rectal cancer surgery: a systematic review and meta-analysis. Surgeon 2010; 8: 341-352.
We acknowledge Dianne O’Connell, David Goldsbury, Michael Barton, Ian Olver and John Stubbs, who are co-investigators on the study team. We also thank Cancer Australia for providing funding for this project; the Riverina Division of General Practice and Primary Health, Macarthur Division of General Practice, Adelaide Western General Practice Network, and Rural Doctors Association of Queensland for assisting with recruitment of study participants; and Jackie Street for assisting with data collection.