SynthesisBritish journal of cancer2010
Diagnostic accuracy systematic review of rectal bleeding in combination with other symptoms, signs and tests in relation to colorectal cancer.
Synthesis in British journal of cancer, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Systematic review of clinical features of suspected colorectal cancer in primary care.Canadian family physician Medecin de famille canadien · 2014Pooled it
- Guideline for referral of patients with suspected colorectal cancer by family physicians and other primary care providers.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
- 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
- Detection of cancers and advanced adenomas in asymptomatic participants in colorectal cancer screening: a cross-sectional study.BMJ open · 2021Trial
- Emergency Diagnostic Phenotypes and Differential Survival in Colorectal Cancer: A Real-World Cohort Study.Diagnostics (Basel, Switzerland) · 2026Article
- Cheminformatics-based screening and evaluation of phytochemicals as CDK2 inhibitors in colorectal cancer therapy.PloS one · 2025Article
- The Value of Colonoscopy in Assessing Rectal Bleeding in Patients Referred From Outpatient Care Units in Erbil, Iraq.Cureus · 2024Article
- Review
- 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
- Interval colonoscopy following acute diverticulitis should not be discouraged yet: results from a retrospective cohort.Surgical endoscopy · 2021Article
- Impact of colorectal cancer screening participation in remote northern Canada: A retrospective cohort study.World journal of gastroenterology · 2020Article
- An Electronic Clinical Decision-Making Tool for Patients with Suspected Colorectal Cancer-Preliminary Evaluation in Patients Presenting with Rectal Bleeding.Journal of the Canadian Association of Gastroenterology · 2020Article
- In silico design and molecular docking study of CDK2 inhibitors with potent cytotoxic activity against HCT116 colorectal cancer cell line.Journal, genetic engineering & biotechnology · 2020Article
- Evaluation of MALAT1 promoter DNA methylation patterns in early colorectal lesions and tumors.Gastroenterology and hepatology from bed to bench · 2019Article
- Two-year retrospective analysis of patients undergoing direct to procedure flexible sigmoidoscopy investigation with rectal bleeding as a primary complaint.Endoscopy international open · 2018Article
- Article
- Health-Seeking Behavior and Barriers to Care in Patients With Rectal Bleeding in Nigeria.Journal of global oncology · 2017Article
- Symptoms, signs, and tests: The general practitioner's comprehensive approach towards a cancer diagnosis.Scandinavian journal of primary health care · 2015Article
- The role of primary care in early detection and follow-up of cancer.Nature reviews. Clinical oncology · 2014Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundRectal bleeding is a recognised early symptom of colorectal cancer. This study aimed to assess the diagnostic accuracy of symptoms, signs and diagnostic tests in patients with rectal bleeding in relation to risk of colorectal cancer in primary care.
methodsDiagnostic accuracy systematic review. Medline (1966 to May 2009), Embase (1988 to May 2009), British Nursing Index (1991 to May 2009) and PsychINFO (1970 to May 2009) were searched. We included cohort studies that assessed the diagnostic utility of rectal bleeding in combination with other symptoms, signs and diagnostic tests in primary care. An eight-point quality assessment tool was produced to assess the quality of included studies. Pooled positive likelihood ratios (PLRs), sensitivities and specificities were calculated.
resultsEight studies incorporating 2323 patients were included. Average weighted prior probability of colorectal cancer was 7.0% (range: 3.3-15.4%, median: 8.1%). Age > or = 60 years (pooled PLR: 2.79, 95% confidence interval (CI) 2.00-3.90), weight loss (pooled PLR: 1.89, 95% CI: 1.03-3.07) and change in bowel habit (pooled PLR: 1.92, 95% CI: 0.54-3.57) raise the probability of colorectal cancer into the range of referral to secondary care but do not conclusively 'rule in' the diagnosis. Presence of severe anaemia has the highest diagnostic value (pooled PLR: 3.67, 95% CI: 1.30-10.35), specificity 0.95 (95% CI: 0.93-0.96), but still only generates a post-test probability of 21.6%.
conclusionsIn patients with rectal bleeding who present to their general practitioner, additional 'red flag' symptoms have modest diagnostic value. These findings have implications in relation to recommendations contained in clinical practice guidelines.
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