ArticleBMC family practice2021
Symptoms and signs of colorectal cancer, with differences between proximal and distal colon cancer: a prospective cohort study of diagnostic accuracy in primary care.
Article in BMC family practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 2 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
53 citing papers in PubMed, 2 syntheses or guidelines pooled it, 92 citations in OpenAlex.
- Effects of Psycho-education Interventions on Colorectal Cancer Patients: A systematic review and meta-analysis.Journal of cancer education : the official journal of the American Association for Cancer Education · 2023Pooled it
- Association between smoking and colorectal cancer in Eastern Mediterranean Regional Office (EMRO): A systematic review and meta-analysis.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology AssociationPooled it
- Differential diagnosis of solitary rectal ulcer syndrome and early rectal cancer via endorectal ultrasound: a retrospective matched case-control study.BMC gastroenterology · 2026Article
- Specialized healthcare diagnostic events within one year preceding colorectal cancer diagnosis.Acta oncologica (Stockholm, Sweden) · 2026Article
- Symptom network in patients with colorectal cancer during the perioperative period.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Navigating the Colorectal Cancer Maze: Unveiling Pathways To Diagnosis, Management, Pathophysiology and Prevention.Current oncology reports · 2025Review
- Exploring colorectal cancer patients' diagnostic pathways and general practitioners' assessment of the diagnostic processes: a Danish survey study.Scandinavian journal of primary health care · 2025Article
- Factors Associated with Attending to the Colorectal Cancer Screening Services among at-Risk Individuals in a Community Care Hospital: A Cross-Sectional Analytical Study.Asian Pacific journal of cancer prevention : APJCP · 2025Article
- Multiclassification of Colorectal Polyps from Colonoscopy Images Using AI for Early Diagnosis.Diagnostics (Basel, Switzerland) · 2025Article
- Surgical and oncological outcomes in transverse colon carcinoma: does tumor sublocation make a difference?Langenbeck's archives of surgery · 2025Article
- Cracking the Code of Colorectal Cancer Screening: An Overview With a Focus on Current and Emerging Screening Methods.Cureus · 2025Review
- Transcriptome-Wide Analysis and Experimental Validation from FFPE Tissue Identifies Stage-Specific Gene Expression Profiles Differentiating Adenoma, Carcinoma In-Situ and Adenocarcinoma in Colorectal Cancer Progression.International journal of molecular sciences · 2025Article
- Right-Sided Versus Left-Sided Colon Cancer-A 5-Year Single-Center Observational Study.Cancers · 2025Article
- Trends, global comparisons, and projections of early onset colorectal cancer burden in China based on GBD study 2021.Scientific reports · 2025Article
- Functional and Structural Investigation of Myenteric Neurons in the Human Colon.Gastro hep advances · 2025Article
- Network meta-analysis and cost-effectiveness analysis comparing Cetuximab-β and Cetuximab for Chinese patients with RAS/BRAF wild-type metastatic colorectal cancer.Frontiers in pharmacology · 2025Article
- A Qualitative Study on the Supportive Care Needs Preferences of Older Colorectal Cancer Patients: Insights from Patient Experiences.Patient preference and adherence · 2025Article
- Assessment of the relationship between gut microbiota, inflammatory markers, and colorectal cancer.Frontiers in cellular and infection microbiology · 2025Article
- Article
- Targeting Invasion: The Role of MMP-2 and MMP-9 Inhibition in Colorectal Cancer Therapy.Biomolecules · 2024Review
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn an abdominal symptom study in primary care in six European countries, 511 cases of cancer were recorded prospectively among 61,802 patients 16 years and older in Norway, Denmark, Sweden, Netherlands, Belgium and Scotland. Colorectal cancer is one of the main types of cancer associated with abdominal symptoms; hence, an in-depth subgroup analysis of the 94 colorectal cancers was carried out in order to study variation in symptom presentation among cancers in different anatomical locations.
methodInitial data capture was by completion of standardised forms containing closed questions about symptoms recorded during the consultation. Follow-up data were provided by the GP after diagnosis, based on medical record data made after the consultation. GPs also provided free text comments about the diagnostic procedure for individual patients. Fisher's exact test was used to analyse differences between groups.
resultsAlmost all symptoms recorded could indicate colorectal cancer. 'Rectal bleeding' had a specificity of 99.4% and a PPV of 4.0%. Faecal occult blood in stool (FOBT) or anaemia may indicate gastrointestinal bleeding: when these symptoms and signs were combined, sensitivity reached 57.5%, with 69.2% for cancer in the distal colon. For proximal colon cancers, none of 18 patients had 'Rectal bleeding' at the initial consultation, but three of the 18 did so at a later consultation. 'Abdominal pain, lower part', 'Constipation' and 'Distended abdomen, bloating' were less specific and also less sensitive than 'Rectal bleeding', and with PPV between 0.7% and 1.9%.
conclusionsApart from rectal bleeding, single symptoms did not reach the PPV 3% NICE threshold. However, supplementary information such as a positive FOBT or persistent symptoms may revise the PPV upwards. If a colorectal cancer is suspected by the GP despite few symptoms, the total clinical picture may still reach the NICE PPV threshold of 3% and justify a specific referral.
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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.