Measures to Increase the Effectiveness of Fast Track Colorectal Clinics for Iron Deficiency Anaemia.
Measures to Increase the Effectiveness of Fast Track Colorectal Clinics for Iron Deficiency Anaemia.
A retrospective cohort study was conducted from 2016-18 in a single busy district general
 hospital providing services to a population of 700,000 people.

 In the study, patients with true IDA (low MCV and ferritin) were found to be more likely to
 have Colorectal cancer compared to any other type of anaemia which confirmed the latest
 guidelines for management of IDA. Compared to symptoms, only the presence of a mass on
 abdominal examination and rectal examination was found to be more likely associated with
 cancer.
Although there are strict and specific guidelines for referring patients with iron deficiency
 anaemia (IDA) to fast track colorectal cancer (FT CRC) clinics for further assessment and
 investigation, patients with other types of anaemia are still referred by primary care
 physicians in the UK. Investigators aim was to find out whether this practice is correct, or
 if it is causing an overburden on colorectal clinics and endoscopy services. Investigators
 also want to find out whether true/absolute IDA has a higher predictive value for diagnosing
 colorectal cancer (CRC) compared to other types of anaemia and specific bowel symptoms.

 Investigator's hypothesis was that patients with IDA are more likely to have CRC compared to
 patients with no anaemia or non-IDA anaemia. By confirming this hypothesis, Investigators can
 identify high risk patients from the population who can then be preferentially subjected to
 investigations mandated by guidelines. This strategy can help to increase the diagnostic
 yield of FT CRC clinics.

 A retrospective cohort study was conducted from 2016-18 in a single busy district general
 hospital providing services to a population of 700,000 people.

 In the study, patients with true IDA (low MCV and ferritin) were found to be more likely to
 have CRC compared to any other type of anaemia which confirmed the latest guidelines for
 management of IDA. Compared to symptoms, only the presence of a mass on abdominal examination
 and rectal examination was found to be more likely associated with cancer.

 Physicians should be able to stratify patients based on blood indices when referring them to
 FT CRC clinics. Diagnostic yield of these clinics can be increased if clinicians strictly
 adhere to fast track guidelines and confirm true IDA before referring patients to clinic.
Inclusion Criteria:

 - Patients with age more than 18 years Presenting to fast track colorectal clinic

 1. With bowel symptoms

 2. Presenting with anaemia

 3. Rectal bleeding

 Exclusion Criteria:

 -  Any patient presenting through routine colorectal clinics

 1. With bowel symptoms

 2. Presenting with anaemia

 3. Rectal bleeding Aged less than 18 years