Prediction of colorectal cancer by a patient consultation questionnaire and scoring system: a prospective study

Selvachandran, S. N.; Hodder, Rupert; Ballal, Mohammed; Jones, Peter W.; Cade, David

doi:10.1016/s0140-6736(02)09549-1

Cited by 141 publications

(186 citation statements)

References 15 publications

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“…Investigation of high-risk factors by HRFQ has been used in the diagnosis of CRC in clinical processes (24,25), but it is rarely used in CRC mass screening. From previous studies, HRFQ could be one of the primary screening methods for colorectal neoplasm in the population (8); however, fewer data were reported.…”

Section: Discussionmentioning

confidence: 99%

Performance of a Colorectal Cancer Screening Protocol in an Economically and Medically Underserved Population

Cai

Zhang

Zhu

et al. 2011

Cancer Prevention Research

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The performance of combining fecal immunochemical tests (FITs) and a high-risk factor questionnaire (HRFQ) in colorectal cancer (CRC) screening in economically and medically underserved populations is uncertain. This study investigated the performance of a CRC screening protocol of combining FITs and an HRFQ as primary screening methods in a rural Chinese population. A CRC mass screening was conducted using FITs and an HRFQ as the first and colonoscopy as the second stage of screening in Jiashan, [2007][2008][2009]. The target population was 31,963 residents in three communities. The compliance was 84.7% for HRFQ, 76.4% for FITs, and 78.7% for colonoscopy. The detected rates of cancer, adenoma, nonadenomatous polyps, and advanced neoplasm were 2.7%, 14.8%, 5.9%, and 8.9% by FITs, which were higher than those by HRFQ (0.5%, 9.2%, 4.8%, and 3.8%, respectively). There was no significant difference in detected rate for nonadenomatous polyps between FITs and HRFQ. A total of 41.2% adenomas, 53.2% nonadenomatous polyps, and 29.8% advanced neoplasms were detected by HRFQ but missed by FITs. Positive predictive value of the screening protocol of combining FITs and HRFQ for advanced neoplasm was 5.7%, which was higher than FITs alone. Men had a higher prevalence of advanced neoplasm than women. Results indicate that combining FITs and HRFQ as primary screening methods is an efficient CRC screening strategy in economically and medically underserved populations.

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Section: Discussionmentioning

confidence: 99%

Performance of a Colorectal Cancer Screening Protocol in an Economically and Medically Underserved Population

Cai

Zhang

Zhu

et al. 2011

Cancer Prevention Research

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“…8 This high figure drops to 1.2% in non-selected primary care patient cohort. 19,25 Likewise, colonoscopy findings in patients with abdominal pain compared to asymptomatic patients showed no difference in the detection of major colorectal diseases. 27 The combinations of two or more symptoms can increase the predictive ability to detect colorectal cancer.…”

Section: Discussionmentioning

confidence: 96%

“…Most of isolated symptoms lack sensitivity and specificity and in clusters they increase the likelihood of cancer. 19 Most patients referred to secondary centres with colorectal cancers have more than one symptom (85%). 13 Furthermore, these symptoms are subjected to selection bias which affects their predictive value in both the primary and secondary care settings.…”

Section: Discussionmentioning

confidence: 99%

“…27 The combinations of two or more symptoms can increase the predictive ability to detect colorectal cancer. 19 The association of rectal bleeding and change of bowel habit is described in many studies. 25 Likewise, the combination of weight loss and rectal bleeding or change in bowel habits increases the positive predictive value.…”

Section: Discussionmentioning

confidence: 99%

“…25 Likewise, the combination of weight loss and rectal bleeding or change in bowel habits increases the positive predictive value. 19 Despite the low predictive value of abdominal pain, its combination with rectal bleeding can raise its predictive value significantly. 25 In our study, 79% of patients had more than one symptom in their presentation.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic Yield of Flexible Sigmoidoscopy in Symptomatic Population: An Insight to Rapid Access Sigmoidoscopy Clinic

Ahmed¹,

Sadadcharam²,

Lynch³

et al. 2015

Surg Res Open J

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Aim: The study aim was to investigate the correlations between suspicious lower GI symptoms and endoscopic findings in symptomatic population using flexible sigmoidoscopy. Methods:Retrospective review of all rapid access sigmoidoscopy clinic referrals was performed. Clinical, sigmoidoscopy findings and outcome were reviewed. Patients were further monitored for over five years for new cancers.Results: A total of 445 patients met the inclusion criteria. Most patients (87.2%) had a flexible sigmoidoscopy in their first visit; 41.2% had barium enema to investigate proximal bowel. Polyp detection rate was 12.6% with an average distance of 23.1±18.9 cm from the anal verge. Passing mucus (p=0.05) and incontinence (p=0.035) were the only predictive symptoms for polyps. Cancer detection rate was 7%. Almost 93% of cancers were detected with the flexible sigmoidoscope alone with an average distance of 23.1±16.6 cm with majority being advanced as 17.9% had Duke's A. Weight loss (p=0.005), tenesmus (p=0.006) and passing mucus per rectum (p=0.008) were three predictive symptoms on univariate and multivariate analysis. One patient developed a primary cancer 5 years from his index sigmoidoscopy. Substantial savings were achieved using this model of investigation.conclusion: Flexible sigmoidoscopy is easy, safe, sensitive and cost effective investigation for patients with suspicious lower colonic symptoms.

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Interventions before consultations for helping patients address their information needs

Kinnersley

Edwards

Hood

et al. 2007

Cochrane Database of Systematic Reviews

140

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Interventions before consultations designed to help patients address their information needs within consultations produce limited benefits to patients. Further research could explore whether the quality of questions is increased, whether anxiety before consultations is reduced, the effects on other outcomes and the impact of training and the timing of interventions. More studies need to consider the timing of interventions and possibly the type of training provided to clinicians.

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Prediction of colorectal cancer by a patient consultation questionnaire and scoring system: a prospective study

Cited by 141 publications

References 15 publications

Performance of a Colorectal Cancer Screening Protocol in an Economically and Medically Underserved Population

Performance of a Colorectal Cancer Screening Protocol in an Economically and Medically Underserved Population

Diagnostic Yield of Flexible Sigmoidoscopy in Symptomatic Population: An Insight to Rapid Access Sigmoidoscopy Clinic

Interventions before consultations for helping patients address their information needs

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