Robertson, R., Campbell, C., Weller, D.P., Elton, R., Mant, D., Primrose, J., Nugent, K., Macleod, U. and Sharma, R. (2006) Predicting colorectal cancer risk in patients with rectal bleeding. British Journal of General Practice, 56 (531), 763-767.
Abstract
Background Rectal bleeding is an important symptom of colorectal cancer but has low predictive value in primary care. Aim To determine which characteristics of rectal bleeding, along with other factors, are predictive of colorectal cancer. Design of study Observation study of patients with rectal bleeding referred to an open-access diagnostic clinic. Setting Primary care, southern England. Method Symptom data were collected, using a self-completed questionnaire. Logistic regression techniques were used to determine predictors of colorectal cancer. Results There were 604 patients in the study and 22 (3.6%, 95% confidence interval [CI] = 2.0% to 5.2%) were diagnosed with colorectal cancer. Significant predictors of colorectal cancer were found to be age (= 70 years: OR = 8.2, 95% CI = 2.1 to 31.8) and blood mixed with the stool (Likelihood ratio [LR] 1.5; adjusted OR = 3.8; 95% CI = 1.4 to 10.5). Presence of haemorrhoids associated with bright red bleeding not mixed with stool reduced the likelihood of cancer (OR = 0.4, 95% CI = 0.1 to 1.2) but did not eliminate it - a cancer was present in 2% of patients with these symptoms. Conclusion Patient-reported type of rectal bleeding as an isolated symptom has insufficient diagnostic value to be useful in general practice. By studying referred patients, we may even have overestimated its value. At best, it could be useful as a component of a composite symptom score to guide referral decisions
This record has no associated files available for download.
More information
Identifiers
Catalogue record
Export record
Contributors
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.