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Colorectal cancer risks quantified
Date:4/16/2009

Although the presenting features of colorectal cancer are well known, the risks they confer are less well defined. New research published in the open access journal BMC Medicine describes the exact risks posed by eight clinical features for the development of colorectal cancer in a large group of patients.

William Hamilton led a team of researchers from the Universities of Bristol and Birmingham who studied the primary care records of 5,477 colorectal cancer patients and 38,314 controls. He said, "General practitioners (GPs) gain relatively little experience in the diagnosis of colorectal cancer because the incidence is about one per GP per year, and only a proportion of these are diagnosed in primary care. Our findings strengthen the view that rectal bleeding carries a high enough risk to warrant investigation irrespective of other symptoms. Current guidance requires persistence of bleeding for 6 weeks, or accompanying diarrhoea. In our opinion, these additional requirements are unnecessary."

The authors found that the highest risks were conferred by rectal bleeding and change in bowel habit. For men over 60 years, rectal bleeding positive predictive values (PPVs) ranged from 2.4-4.5%. For women, the figures were lower, but still in the 2-3% range. Dr Hamilton added, "Change in bowel habit is less simple: GPs contributing to the database must have been using this term very differently from the separate terms of constipation and diarrhoea, in that the PPVs for change in bowel habit were considerably higher. We cannot know what features led GPs to write change in bowel habit in the notes in preference to the specific motility symptoms however, from our results it is clear that they were identifying a riskier feature, and one that warrants investigation".

The PPVs of the other presenting features were lower, but still significant. The values for constipation, diarrhoea, abdominal pain and loss of weight were all below 1.5%, con
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Contact: Graeme Baldwin
graeme.baldwin@biomedcentral.com
44-078-774-11853
BioMed Central
Source:Eurekalert

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