Fast-Track Referral

Fast-track referral analyses were restricted to patients with new-onset red-flag symptoms or anaemia because NICE guidance indicates urgent referral for these patients. Among patients with new-onset change in bowel habit, rectal bleeding, or anaemia, overweight was associated with higher likelihood of fast-track referral for colon cancer compared with normal weight. There was no evidence that BMI category was associated with fast-track referral among rectal cancer patients. Obesity was not clearly associated with fast-track referral. The finding that overweight, but not obesity, was associated with fast-track referral may indicate that clinicians use non-fast-track endoscopy pathways for some patients with obesity. Fast-track referral is the preferred diagnostic route when general practitioners suspect cancer.