ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2006
Predicting colorectal cancer risk in patients with rectal bleeding.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 5 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 5 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Cancer diagnostic tools to aid decision-making in primary care: mixed-methods systematic reviews and cost-effectiveness analysis.Health technology assessment (Winchester, England) · 2020Pooled it
- Systematic review of clinical features of suspected colorectal cancer in primary care.Canadian family physician Medecin de famille canadien · 2014Pooled it
- Most bowel cancer symptoms do not indicate colorectal cancer and polyps: a systematic review.BMC gastroenterology · 2011Pooled it
- The diagnostic value of symptoms for colorectal cancer in primary care: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2011Pooled it
- Value of symptoms and additional diagnostic tests for colorectal cancer in primary care: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2010Pooled it
- Insights into Colorectal Cancer Screening Awareness: A Study in the Community of Taif City.Journal of pharmacy & bioallied sciences · 2024Article
- Creating a Safety Net Process to Improve Colon Cancer Diagnosis in Patients With Rectal Bleeding.The Permanente journal · 2022Article
- How can we better identify patients with rectal bleeding who are at high risk of colorectal cancer? An observational study.International journal of colorectal disease · 2022Observational
- A Review of GC-Based Analysis of Non-Invasive Biomarkers of Colorectal Cancer and Related Pathways.Journal of clinical medicine · 2020Review
- Endoscopic Findings in Patients Under the Age of 40 Years with Hematochezia in Singapore.Clinical endoscopy · 2020Article
- Two-year retrospective analysis of patients undergoing direct to procedure flexible sigmoidoscopy investigation with rectal bleeding as a primary complaint.Endoscopy international open · 2018Article
- Evaluation of a fecal immunochemistry test prior to colonoscopy for outpatients with various indications.Clinical and experimental gastroenterology · 2017Article
- Hematochezia in the young patient: a review of health-seeking behavior, physician attitudes, and controversies in management.Digestive diseases and sciences · 2010Review
- Alarm symptoms and identification of non-cancer diagnoses in primary care: cohort study.BMJ (Clinical research ed.) · 2009Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRectal bleeding is an important symptom of colorectal cancer but has low predictive value in primary care.
aimTo determine which characteristics of rectal bleeding, along with other factors, are predictive of colorectal cancer. DESIGN OF STUDY: Observation study of patients with rectal bleeding referred to an open-access diagnostic clinic.
settingPrimary care, southern England.
methodSymptom data were collected, using a self-completed questionnaire. Logistic regression techniques were used to determine predictors of colorectal cancer.
resultsThere were 604 patients in the study and 22 (3.6%, 95% confidence interval [CI] = 2.0% to 5.2%) were diagnosed with colorectal cancer. Significant predictors of colorectal cancer were found to be age (<50 years: odds ratio [OR] = 1; 50-69 years: OR = 5.1, 95% CI = 1.4 to 18.6; > or = 70 years: OR = 8.2, 95% CI = 2.1 to 31.8) and blood mixed with the stool (Likelihood ratio [LR] 1.5; adjusted OR = 3.8; 95% CI = 1.4 to 10.5). Presence of haemorrhoids associated with bright red bleeding not mixed with stool reduced the likelihood of cancer (OR = 0.4, 95% CI = 0.1 to 1.2) but did not eliminate it--a cancer was present in 2% of patients with these symptoms.
conclusionPatient-reported type of rectal bleeding as an isolated symptom has insufficient diagnostic value to be useful in general practice. By studying referred patients, we may even have overestimated its value. At best, it could be useful as a component of a composite symptom score to guide referral decisions.
Indexed as
Identifiers
17007706PMC1920716W1907371505What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.