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

Autor: McCulloch SM; Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden., Aziz I; Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden., Polster AV; Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden., Pischel AB; Sahlgrenska University Hospital, Sahlgrenska Hospital, Gothenburg, Sweden., Stålsmeden H; Kungälv Hospital, Kungälv, Sweden., Shafazand M; Sahlgrenska University Hospital, Östra Hospital, Gothenburg, Sweden., Block M; Sahlgrenska University Hospital, Östra Hospital, Gothenburg, Sweden., Byröd G; Sahlgrenska University Hospital, Mölndal Hospital, Mölndal, Sweden., Lindkvist B; Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden.; Sahlgrenska University Hospital, Sahlgrenska Hospital, Gothenburg, Sweden., Törnblom H; Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden.; Sahlgrenska University Hospital, Sahlgrenska Hospital, Gothenburg, Sweden., Jonefjäll B; Kungälv Hospital, Kungälv, Sweden., Simren M; Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden.; Sahlgrenska University Hospital, Sahlgrenska Hospital, Gothenburg, Sweden.
Jazyk: angličtina
Zdroj: United European gastroenterology journal [United European Gastroenterol J] 2020 Mar; Vol. 8 (2), pp. 211-219. Date of Electronic Publication: 2019 Nov 06.
DOI: 10.1177/2050640619888040
Abstrakt: 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.
Databáze: MEDLINE
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