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2-Week Rule CT Scans Ordered by GP to Assess for Pancreatic Cancer. Are they Meeting The Referral Criteria?
EP34321
Poster Title: 2-Week Rule CT Scans Ordered by GP to Assess for Pancreatic Cancer. Are they Meeting The Referral Criteria?
Submitted on 04 Nov 2020
Author(s): Abdelbagi I, Rai H
Affiliations: Radiology Department, Walsall Manor Hospital
This poster was presented at 4/11/2020
Poster Views: 30
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Poster Information
Abstract: 2-week rule CT scans ordered by GP to assess for pancreatic cancer. Are they meeting the referral criteria?
Abdelbagi I(1), Rai H(1)
(1)Walsall Healthcare NHS Trust.

Introduction:
NICE guidelines (NG12) has set out specific criteria for referral in suspected pancreatic cancer and recommends urgent CT scans (within 2 weeks). The aim of this audit is to assess whether referrals from GPs for 2 week wait CT pancreas scans are meeting the criteria set by NICE with 100% target.(1)

Methodology:
Consecutive requests from GPs for 2 week wait CT pancreas for suspected pancreatic CA were reviewed between April 2019 and February 2020. Those requests for reasons other than suspected pancreatic CA were excluded. Patients’demographics, request clinical information and CT reports were reviewed.

Results:
A total of 21 patients were included. Mean age was 67 years, (range 48 - 78). 52% (n=11) were males. 28% of patients (n=7) were below the age of 60 years. 62% (n=13) did not meet the referral criteria set by NICE. Of these, 1 patient (4.7%) was found to have pancreatic cancer.
The remaining 38% (n=8) have met the NICE referral criteria and of those 1 patient (4.7%) was found to have pancreatic cancer.

Conclusion:
Although the majority of requests did not meet the NICE criteria, we think that they were clinically appropriate requests as they were vetted necessary and performed by the radiology department. We suggest that NICE may consider expanding the criteria for referring patients for CT scans to exclude pancreatic cancer to include patients younger than the age of 60, especially with symptoms such as a rapid rise in Hba1c or risk factors such as chronic pancreatitis and excessive alcohol intake.

Summary: 2-week rule CT scans ordered by GPs to assess for pancreatic cancer. Are they meeting the referral criteria?
This was an audit performed at the Radiology Department of Walsall Manor Hospital. The aim was to assess whether 2 week wait CT pancreas requests met the referral criteria set by NICE. The results showed the majority of requests did not meet these criteria. However, we felt that these requests were clinically appropriate as they were vetted and performed by the radiology department.
References:
1. NICE guideline Suspected Cancer: recognition and referral [NG12]
2. International variation in adherence to referral guidelines for suspected cancer: a secondary analysis of survey data. Br J Gen Pract, 2016 Feb: e106 – e113.

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