Dear GP/Family Doctor,

It has now been over six years since the launch of the FastTrack (FT) referral system for suspected cancer patients in the community. Our first cancer pathway—Colorectal—remains one of the most utilized, with approximately 400 referrals received annually. Of these, around 60% proceed to endoscopic investigation ( remaining led to an SOP and/or Imaging) , leading to the detection of an average of 20 colon cancers per year. The primary goal of this pathway is to detect cancers as early and efficiently as possible.

Following an audit of 550 colon FT referrals an improved Urgency Score was developed, and the referral form (Colon Ticket) has been upgraded accordingly. This revised form enables the FT Team to triage and process referrals more systematically.

New key symptoms have been incorporated into the form, including:

• Positive FOB (Faecal Occult Blood)
• New-onset anaemia or significant haemoglobin drop
• Unintentional weight loss

Please note: It is crucial that symptoms are ticked directly on the form. Entries made only in the free-text field will not contribute to the Urgency Score and may delay triage.

A  “Set as No” button has been provided to facilitate filling of Form. You can press this in the Medical and Drug History sections and press the necessary yes were applicable.

We are pleased to report a significant reduction in average waiting times for patients diagnosed with colon cancer via the FT pathway—from several months in 2018, to 35 days in 2024, and now down to 28 days in 2025.

We strongly encourage you to continue utilizing the FT pathway when clinical suspicion is high. Early referral can make a critical difference in outcomes.