Table 1.
The indications for referral, tests requested as guided by the GP letter, and tests requested after consultation with the patient
| Indication for urgent referral | Rectal bleeding with a change in bowel habit to looser and/or increased frequency of defecation persistent for 6 weeks |
| Tests based on GP letter | Flexible sigmoidoscopy(3), colonoscopy (46), CT scan (11), barium enema (2) |
| Tests requested after consultation | Flexible sigmoidoscopy(5), colonoscopy (42), CT scan (14), barium enema (3) |
| Patients with changed tests | 15 of 51 (29%) |
| Indication for urgent referral | Rectal bleeding persistently without anal symptoms (soreness, discomfort, itching, lumps, and prolapse as well as pain) |
| Tests based on GP letter | Flexible sigmoidoscopy(10), colonoscopy (31), CT scan (3), barium enema (1) |
| Tests requested after consultation | Flexible sigmoidoscopy(8), colonoscopy (31), CT scan (4), barium enema (2) |
| Patients with changed tests | 10 of 42 (24%) |
| Indication for urgent referral | Change in bowel habit to looser stools and/or increased frequency of defecation without rectal bleeding and persistent for 6 weeks |
| Tests based on GP letter | Flexible sigmoidoscopy(2), colonoscopy (28), CT scan (8), barium enema (41) |
| Tests requested after consultation | Flexible sigmoidoscopy(4), colonoscopy (34), CT scan (16), barium enema (31) |
| Patients with changed tests | 26 of 72 (36%) |
| Indication for urgent referral | A definite palpable rectal (not pelvic) mass |
| Tests based on GP letter | Flexible sigmoidoscopy(0), colonoscopy (11), CT scan (10), barium enema (0) |
| Tests requested after consultation | Flexible sigmoidoscopy(5), colonoscopy (5), CT scan (6), barium enema (1) |
| Patients with changed tests | 8 of 12 (67%) |
| Indication for urgent referral | A definite palpable right-sided abdominal mass |
| Tests based on GP letter | Flexible sigmoidoscopy(0), colonoscopy (7), CT scan (11), barium enema (0) |
| Tests requested after consultation | Flexible sigmoidoscopy(0), colonoscopy (6), CT scan (11), barium enema (0) |
| Patients with changed tests | 1 of 11 (9%) |
| Indication for urgent referral | Iron-deficiency anaemia without an obvious cause (haemoglobin < 11 g/dl or < 10 g/dl in postmenopausal women) |
| Tests based on GP letter | Flexible sigmoidoscopy(0), colonoscopy (25), CT scan (5), OGD (23) |
| Tests requested after consultation | Flexible sigmoidoscopy(1), colonoscopy (24), CT scan (10), OGD (19) |
| Patients with changed tests | 7 of 29 (24%) |