ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2016
Identification of patients with non-metastatic colorectal cancer in primary care: a case-control study.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 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
- 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
- Cancer risk in patients with recurrent or persistent symptoms: a systematic review.The Lancet regional health. Europe · 2026Review
- A machine learning tool for identifying metastatic colorectal cancer in primary care.Scandinavian journal of primary health care · 2025Article
- Colorectal cancer screening in adults aged 45-49: provider availability, CT colonography access, and screening rates.Journal of the National Cancer Center · 2025Article
- Engaging primary care physicians is critical in the screening and diagnosis of colorectal cancer at safety-net hospital systems.Surgery open science · 2024Article
- Validation of a diagnostic prediction tool for colorectal cancer: a case-control replication study.Family practice · 2023Article
- Complete Blood Count Alterations Prior to the Diagnosis of Colorectal Cancer May Help in the Detection of Synchronous Liver Metastases.Journal of clinical medicine · 2023Article
- The performance of FIT-based and other risk prediction models for colorectal neoplasia in symptomatic patients: a systematic review.EClinicalMedicine · 2023Review
- Impact of Patient Comorbidities on Presentation Stage of Breast and Colon Cancers.Annals of surgical oncology · 2023Article
- Anemia can predict the prognosis of colorectal cancer in the pre-operative stage: a retrospective analysis.World journal of surgical oncology · 2021Article
- Pluralistic task shifting for a more timely cancer diagnosis. A grounded theory study from a primary care perspective.Scandinavian journal of primary health care · 2021Article
- Shifting between roles of a customer and a seller - patients' experiences of the encounter with primary care physicians when suspicions of cancer exist.International journal of qualitative studies on health and well-being · 2021Article
- Virtual Screening for Biomimetic Anti-Cancer Peptides fromMolecules (Basel, Switzerland) · 2021Article
- Symptoms and signs of colorectal cancer, with differences between proximal and distal colon cancer: a prospective cohort study of diagnostic accuracy in primary care.BMC family practice · 2021Article
- Review
- GPs' perspectives of the patient encounter - in the context of standardized cancer patient pathways.Scandinavian journal of primary health care · 2020Article
- The association between unexpected weight loss and cancer diagnosis in primary care: a matched cohort analysis of 65,000 presentations.British journal of cancer · 2020Article
- The diagnostic value of a change in bowel habit for colorectal cancer within different age groups.United European gastroenterology journal · 2020Article
- What are the clinical symptoms and physical signs for non-small cell lung cancer before diagnosis is made? A nation-wide multicenter 10-year retrospective study in China.Cancer medicine · 2019Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundColorectal cancer is the third most common cancer worldwide and second most common in Europe. Despite screening, it is often diagnosed at an unfavourable stage.
aimTo identify and quantify features of non-metastatic colorectal cancer in primary care to enable earlier diagnosis by GPs. DESIGN AND
settingA case-control study was conducted using diagnostic codes from national and regional healthcare databases in Sweden.
methodA total of 542 patients diagnosed with non-metastatic colorectal cancer in 2011 and 2139 matched controls were selected from the Swedish Cancer Register (SCR) and a regional healthcare database respectively. All diagnostic codes (according to ICD-10) from primary care consultations registered the year before the date of cancer diagnosis (according to the SCR) were collected from the regional database. Odds ratios were calculated for variables independently associated with non-metastatic colorectal cancer using multivariable conditional logistic regressions. Positive predictive values (PPVs) of these variables were calculated, both individually and in combination with each other.
resultsFive features were associated with colorectal cancer before diagnosis: bleeding, including rectal bleeding, melaena, and gastrointestinal bleeding (PPV 3.9%, 95% confidence interval [CI] = 2.3 to 6.3); anaemia (PPV 1.4%, 95% CI = 1.1 to 1.8); change in bowel habit (PPV 1.1%, 95% CI = 0.9 to 1.5; abdominal pain (PPV 0.9%, 95% CI = 0.7 to 1.1); and weight loss (PPV 1.0%, 95% CI = 0.3 to 3.0); all P-value <0.05. The combination of bleeding and change in bowel habit had a PPV of 13.7% (95% CI = 2.1 to 54.4); for bleeding combined with abdominal pain this was 12.2% (95% CI = 1.8 to 51.2). A risk assessment tool for non-metastatic colorectal cancer was designed.
conclusionBleeding combined with either diarrhoea, constipation, change in bowel habit, or abdominal pain are the most powerful predictors of non-metastatic colorectal cancer and should result in prompt referral for colorectal investigation.
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