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The diagnostic value of a change in bowel habit for colorectal cancer within different age groups

Artikel i vetenskaplig tidskrift
Författare Sofia McCulloch
Imran Aziz
Annikka Polster
A. B. Pischel
H. Stalsmeden
M. Shafazand
M. Block
G. Byrod
Björn Lindkvist
Hans Törnblom
B. Jonefjall
Magnus Simrén
Publicerad i United European Gastroenterology Journal
ISSN 2050-6406
Publiceringsår 2019
Publicerad vid Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition
Språk en
Länkar dx.doi.org/10.1177/2050640619888040
Ämnesord Change in bowel habit, colorectal cancer, visible rectal bleeding, anaemia, primary-care, colonoscopy, features, impact, yield, cost, risk, Gastroenterology & Hepatology
Ämneskategorier Gastroenterologi

Sammanfattning

Background Change in bowel habit as a sole alarm symptom for colorectal cancer is disputed. Objective We investigated the diagnostic value of change in bowel habit for colorectal cancer, particularly as a single symptom and within different age groups. Methods This retrospective cohort study examined colorectal cancer fast track referrals and outcomes across four Swedish hospitals (April 2016-May 2017). Entry criteria constituted one or more of three alarm features: anaemia, visible rectal bleeding, or change in bowel habit for more than 4 weeks in patients over 40 years of age. Patients were grouped as having only change in bowel habit, change in bowel habit plus anaemia/bleeding or anaemia/bleeding only. Results Of 628 patients, 22% were diagnosed with colorectal cancer. There were no cases of colorectal cancer in the only change in bowel habit group under 55 years, while this was 6% for 55-64 years, 8% for 65-74 years and 14% for 75 years and older. Among subjects under 55 years, 2% with anaemia/bleeding had colorectal cancer, this increased to 34% for 55 years and older (P < 0.0001). Change in bowel habit plus anaemia/bleeding gave a colorectal cancer prevalence of 16% in under 55 years and increased to 30% for 55 years and older (P = 0.07). Conclusion Change in bowel habit as the only alarm feature has a low diagnostic yield for colorectal cancer in patients under 55 years.

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