Predictive values of colorectal cancer alarm symptoms in the general population: a nationwide cohort study.

Autor: Rasmussen, Sanne, Haastrup, Peter Fentz, Balasubramaniam, Kirubakaran, Elnegaard, Sandra, Christensen, René dePont, Storsveen, Maria Munch, Søndergaard, Jens, Jarbøl, Dorte Ejg
Zdroj: British Journal of Cancer; Mar2019, Vol. 120 Issue 6, p595-600, 6p, 1 Diagram, 5 Charts
Abstrakt: Background: Alarm symptoms are used in many cancer referral guidelines. The objectives were to determine the 1-year predictive values (PVs) of colorectal cancer (CRC) alarm symptoms in the general population and to describe the proportion of alarm symptoms reported prior to diagnosis.Methods: A nationwide prospective cohort of 69,060 individuals ≥40 years randomly selected from the Danish population was invited to complete a survey regarding symptoms and healthcare-seeking in 2012. Information on CRC diagnoses in a 12-month follow-up came from the Danish Cancer Registry. PVs and positive and negative likelihood ratios were calculated.Results: A total of 37,455 individuals participated (response rate 54.2%). Sixty-four individuals were diagnosed with CRC. The single symptom with the highest positive PVs (PPV) and LR+ was rectal bleeding. PPVs were generally higher among individuals aged ≥75 years and highest among those reporting at least one specific alarm symptom that led to a GP contact.Conclusion: In general, the PPVs of CRC alarm symptoms are low and the NPVs high, especially in the youngest age groups. The LR +  show a relative association with specific symptoms like rectal bleeding. Future campaigns on early diagnosis of CRC should focus on healthcare-seeking when experiencing rectal bleeding and target older people with the highest incidence. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index