Can we improve the efficiency of care in patients with colorectal cancer from the time of their initial referral for colonoscopy to surgical resection

Summary: Delays in the diagnosis and treatment of colon adenocarcinoma are distressing to patients and clinicians alike. Of 224 patients with resected colon cancer identified via a province-wide administrative database, 170 (76%) received their colonoscopy from a gastroenterologist (GI). Patients waited significantly longer between their colonoscopy and surgical resection when the colonoscopy was performed by a GI within an urban city (43 v. 27 d; p = 0.02). The total time from family practice referral to colonoscopy to surgical resection was shorter when a surgeon performed colonoscopy within an urban setting (105 v. 114 d; p = 0.03). In community settings, there were no significant differences in any interval, regardless of which service performed the colonoscopy.