ArticleBMC medicine2009
The risk of colorectal cancer with symptoms at different ages and between the sexes: a case-control study.
Article in BMC medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 7 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
68 citing papers in PubMed, 7 syntheses or guidelines pooled it, 147 citations in OpenAlex.
- Development, validation and effectiveness of diagnostic prediction tools for colorectal cancer in primary care: a systematic review.BMC cancer · 2020Pooled it
- 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
- Understanding the role of GPs' gut feelings in diagnosing cancer in primary care: a systematic review and meta-analysis of existing evidence.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Pooled it
- Weight loss as a predictor of cancer in primary care: a systematic review and meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Pooled it
- Risk prediction models for colorectal cancer in people with symptoms: a systematic review.BMC gastroenterology · 2016Pooled 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
- Positive predictive values of ≥5% in primary care for cancer: systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Pooled it
- Electronic Trigger-Based Intervention to Reduce Delays in Diagnostic Evaluation for Cancer: A Cluster Randomized Controlled Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2015Trial
- Temporal association of constipation and diarrhoea with a subsequent diagnosis of colorectal cancer: a propensity score-matched case-control study using real-world primary care data.BMJ open gastroenterology · 2026Article
- Digital quality measure of potentially avoidable emergency presentations among patients with colorectal cancer.BMJ quality & safety · 2026Article
- Article
- COLOFIT: Development and Internal-External Validation of Models Using Age, Sex, Faecal Immunochemical and Blood Tests to Optimise Diagnosis of Colorectal Cancer in Symptomatic Patients.Alimentary pharmacology & therapeutics · 2025Article
- Article
- Article
- Development and Validation of Risk Prediction Models for Colorectal Cancer in Patients with Symptoms.Journal of personalized medicine · 2023Article
- Review
- Use of faecal immunochemical tests common in patients with suspected colorectal cancer but unrelated to travel distance to secondary care: a population-based study from Swedish primary care.Scandinavian journal of primary health care · 2022Article
- The association between sociodemographic factors and time to diagnosis for colorectal cancer in northern Sweden.European journal of cancer care · 2022Article
- The Underestimated and Overlooked Burden of Diarrhea and Constipation in Cancer Patients.Current oncology reports · 2022Review
- Cultivating Doctors' Gut Feeling: Experience, Temporality and Politics of Gut Feelings in Family Medicine.Culture, medicine and psychiatry · 2022Article
8 more citing papers are in PubMed but not listed here.
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundColorectal cancer is generally diagnosed following a symptomatic presentation to primary care. Although the presenting features of the cancer are well described, the risks they convey are less well known. This study aimed to quantify the risk of cancer for different symptoms, across age groups and in both sexes.
methodsThis was a case-control study using pre-existing records in a large electronic primary care database. Cases were patients aged 30 years or older with a diagnosis of colorectal cancer between January 2001 and July 2006, matched to seven controls by age, sex and practice. All features of colorectal cancer recorded in the 2 years before diagnosis were identified. Features independently associated with cancer were identified using multivariable conditional logistic regression, and their risk of cancer quantified.
resultsWe identified 5477 cases, with 38,314 age, sex and practice-matched controls. Six symptoms and two abnormal investigations (anaemia and microcytosis) were independently associated with colorectal cancer. The positive predictive values of symptoms were: rectal bleeding, positive predictive value for a male aged > or = 80 years 4.5% (95% confidence interval 3.5, 5.9); change in bowel habit 3.9% (2.8, 5.5); weight loss 0.8% (0.5, 1.3); abdominal pain 1.2% (1.0, 1.4); diarrhoea 1.2% (1.0, 1.5) and constipation 0.7% (0.6, 0.8). Positive predictive values were lower in females and younger patients. Only 27% of patients had reported either of the two higher risk symptoms.
conclusionMost symptomatic colorectal cancers present with only a low-risk symptom. There is a need to find a method of identifying those at highest risk of cancer from the large number presenting with such symptoms.
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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.