The two-week rule in colorectal cancer. Can it deliver its promise?

Despite recent advances in technology, a high percentage of patients with colorectal cancer present with disease that is already advanced, leading to an overall 5-year survival rate of 49.6% in men and 50.8% in women. In order to facilitate access to specialist cancer units, across specialities, the Department of Health formulated the NHS Cancer Plan in 2000 which consisted, in part, of the ‘two-week rule’ (TWR). The TWR was launched to ensure that all patients meeting specific referral criteria for suspected colorectal cancer were seen by a hospital specialist within 14 days of referral. The TWR referral system was set up with the intention of identifying 90% of patients with bowel cancer for prompt treatment.