Show simple item record

dc.contributor.authorHoltedahl, Knut
dc.contributor.authorBorgquist, Lars
dc.contributor.authorDonker, Gé A.
dc.contributor.authorBuntinx, Frank
dc.contributor.authorWeller, David
dc.contributor.authorCampbell, Christine
dc.contributor.authorMånsson, Jörgen
dc.contributor.authorHammersley, Victoria
dc.contributor.authorBraaten, Tonje
dc.contributor.authorParajuli, Ranjan
dc.date.accessioned2021-09-21T11:03:19Z
dc.date.available2021-09-21T11:03:19Z
dc.date.issued2021-07-08
dc.description.abstract<i>Background</i> - In 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.<br><br> <i>Method</i> - Initial 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.<br><br> <i>Results</i> - Almost 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%.<br><br> <i>Conclusions</i> - Apart 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.en_US
dc.identifier.citationHoltedahl, Borgquist, Donker, Buntinx, Weller, Campbell, Månsson, Hammersley, Braaten, Parajuli. 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. 2021;22(1):1-13en_US
dc.identifier.cristinIDFRIDAID 1926949
dc.identifier.doi10.1186/s12875-021-01452-6
dc.identifier.issn1471-2296
dc.identifier.urihttps://hdl.handle.net/10037/22593
dc.language.isoengen_US
dc.publisherBMCen_US
dc.relation.journalBMC Family Practice
dc.relation.projectIDinfo:eu-repo/grantAgreement/RCN/BEHANDLING/202663/Norway/Early diagnosis of abdominal cancer in general practice - a cohort study//en_US
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2021 The Author(s)en_US
dc.subjectVDP::Medical disciplines: 700en_US
dc.subjectVDP::Medisinske Fag: 700en_US
dc.titleSymptoms and signs of colorectal cancer, with differences between proximal and distal colon cancer: a prospective cohort study of diagnostic accuracy in primary careen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


File(s) in this item

Thumbnail

This item appears in the following collection(s)

Show simple item record