LAUSR

Abstract Introduction In a climate of rising pressure to ameliorate cancer services, a “straight to test” (STT) model whereby two-week wait (TWW) colorectal referrals undergo an investigative procedure prior to an outpatient assessment has been explored as a method to expedite the clinical pathway. We aim to evaluate the potential for its application in an ethnically diverse region and assess whether this model improves the time to diagnosis compared to the conventional route. Presentation of cases Between September and October 2016, we performed a prospective comparative case series of 132 consecutive TWW colorectal referrals to a district general hospital. Following a two-stage triage process, 24 patients were allocated to a STT group and 108 patients were assessed in clinic first. The times to the first investigation, endoscopic procedure and established diagnosis were compared between the two groups. Discussion The median time to the first investigation was 13.5 days in the STT group versus 24 days in the non-STT group (p  Conclusion A STT approach minimises the time from TWW referral to investigations and diagnosis for patients with suspected colorectal cancer. Application of a STT model may be limited by local population factors including language issues and a high prevalence of medical comorbidity.