Symptomatic Presentation of Early Colorectal Cancer

Abstract

Early colorectal cancers do have significant symptoms which can easily be captured by a PCQ and objective scoring tool in the secondary care setting. Detection of these cancers has the potential to improve survival.

Hematochezia in the Young Patient: A Review of Health-Seeking Behavior, Physician Attitudes, and Controversies in Management

“…The tendency may be to attribute shorter duration of symptoms to early disease and vice versa. This has not been shown in the literature either, with no relation being found between the duration of symptoms and stage or prognosis [21][22][23][24][25]. Blood mixed with or on stool seems to be one finding with a statistically significant independent value when evaluating for CRC, as mentioned above [19,26].…”

“…They found older age, CIBH, and the absence of perianal symptoms as useful predictors of CRC, but with a low sensitivity and specificity (between 59 and 78%). Smith et al, in contrast, reported a large number of patients with CRC having perianal symptoms [21]. They concluded that the presence of these symptoms should not exclude patients from a full colonic investigation.…”

Promoting the early detection of cancer: A systematic review of community pharmacy-based education and screening interventions

“…All the screening tools were previously validated or were constructed from previously validated instruments. The Patient Consultation Questionnaire (PSQ) [27], for identifying patients at risk of colorectal cancer, was used by two of the studies [22,23], while a Breast Cancer Risk Assessment Tool (Gail model) [28] was used in one study. Another study combined a number of existing tools, including assessments for prostate cancer [29] and colorectal cancer [30], to form a Men's Health Risk Assessment Tool (MHRAT) [17]; however, this tool was not checked for validity or reliability.…”

Men's Help-seeking Behavior with Regards to Lower Bowel Symptoms

“…14 Rectal bleeding is a classic and frequent first symptom of CRC and may be present in up to 84% of the cases and also may be prevalent in up to one-third of the general population. 1,7,[15][16][17][18] In contrast, change in bowel habit may be present in up to 77% of the CRC cases and in 10% to 25% of the general population. 7,[16][17][18][19] Lawrenson et al 20 observed that there were up to 200 and 400 cases of CRC per 10,000 patient-years in men and women experiencing change in bowel habit and rectal bleeding, respectively.…”

“…1,7,[15][16][17][18] In contrast, change in bowel habit may be present in up to 77% of the CRC cases and in 10% to 25% of the general population. 7,[16][17][18][19] Lawrenson et al 20 observed that there were up to 200 and 400 cases of CRC per 10,000 patient-years in men and women experiencing change in bowel habit and rectal bleeding, respectively. However, past studies have shown that while rectal bleeding (sensitivity 0.46; positive likelihood ratio 1.9; diagnostic odds ratio 2.6) and weight loss (sensitivity 0.2; positive likelihood ratio 2.5; diagnostic odds ratio 2.9) may have a moderate diagnostic value for CRC, other lower bowel symptoms such as diarrhea, constipation, change in bowel habit, or abdominal pain have poor diagnostic value.…”