Evidence map›Paper›PMID 30563992›Full record

ArticleBritish journal of cancer2019

Whole-colon investigation vs. flexible sigmoidoscopy for suspected colorectal cancer based on presenting symptoms and signs: a multicentre cohort study.

Amanda J Cross, Kate Wooldrage, Emma C Robbins, Kevin Pack, Jeremy P Brown, William Hamilton, Michael R Thompson, Karen G Flashman, Steve Halligan, Siwan Thomas-Gibson and 3 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.8field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 23 citations in OpenAlex.

  1. Article
  2. Review
  3. Review
  4. Nanotechnology for colorectal cancer detection and treatment.World journal of gastroenterology · 2022
    Review
  5. Article
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 1 country.

Amanda J CrossCancer Screening and Prevention Research Group, Department of Surgery and Cancer, Imperial College London, London, UK. amanda.cross@imperial.ac.uk.
Kate WooldrageCancer Screening and Prevention Research Group, Department of Surgery and Cancer, Imperial College London, London, UK.
Emma C RobbinsCancer Screening and Prevention Research Group, Department of Surgery and Cancer, Imperial College London, London, UK.
Kevin PackCancer Screening and Prevention Research Group, Department of Surgery and Cancer, Imperial College London, London, UK.
Jeremy P BrownCancer Screening and Prevention Research Group, Department of Surgery and Cancer, Imperial College London, London, UK.
William HamiltonInstitute of Health Research, University of Exeter Medical School, Exeter, UK.
Michael R ThompsonDepartment of Colorectal Surgery, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK.
Karen G FlashmanDepartment of Colorectal Surgery, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK.
Steve HalliganUniversity College London Centre for Medical Imaging, University College London, London, UK.
Siwan Thomas-GibsonWolfson Unit for Endoscopy, St Mark's Hospital, London, UK.
Margaret VanceWolfson Unit for Endoscopy, St Mark's Hospital, London, UK.
Brian P SaundersWolfson Unit for Endoscopy, St Mark's Hospital, London, UK.
Wendy AtkinCancer Screening and Prevention Research Group, Department of Surgery and Cancer, Imperial College London, London, UK.
Imperial College London · GBSt Mark's Hospital · GBPortsmouth Hospitals NHS Trust · GBQueen Alexandra Hospital · GBUniversity College London · GBUniversity of Exeter · GB

Funding

Cancer Research UK 25004Department of Health 02/02/01
6 · The paper itself

Abstract

backgroundPatients with suspected colorectal cancer (CRC) usually undergo colonoscopy. Flexible sigmoidoscopy (FS) may be preferred if proximal cancer risk is low. We investigated which patients could undergo FS alone.

methodsCohort study of 7375 patients (≥55 years) referred with suspected CRC to 21 English hospitals (2004-2007), followed using hospital records and cancer registries. We calculated yields and number of needed whole-colon examinations (NNE) to diagnose one cancer by symptoms/signs and subsite. We considered narrow (haemoglobin <11 g/dL men; <10 g/dL women) and broad (<13 g/dL men; <12 g/dL women) anaemia definitions and iron-deficiency anaemia (IDA).

resultsOne hundred and twenty-seven proximal and 429 distal CRCs were diagnosed. A broad anaemia definition identified 80% of proximal cancers; a narrow definition with IDA identified 39%. In patients with broad definition anaemia and/or abdominal mass, proximal cancer yield and NNE were 4.8% (97/2022) and 21. In patients without broad definition anaemia and/or abdominal mass, with rectal bleeding or increased stool frequency (41% of cohort), proximal cancer yield and NNE were 0.4% (13/3031) and 234.

conclusionMost proximal cancers are accompanied by broad definition anaemia. In patients without broad definition anaemia and/or abdominal mass, with rectal bleeding or increased stool frequency, proximal cancer is rare and FS should suffice.

Indexed as

AgedAged, 80 and overAnemia, Iron-DeficiencyCohort StudiesColonColonoscopyColorectal NeoplasmsFemaleGastrointestinal HemorrhageHumansMaleMiddle AgedRectumSigmoidoscopy

Identifiers

PMID30563992
PMCPMC6342953
OpenAlexW2905076114

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.