Straightforward assessment to improve identification of people at high risk from colorec...( Authors of a UK study published on THE ...),Health

Colorectal cancer is the second most common cause of death from cancer in the UK, with 30,000 new cases and 19,000 deaths every year. Current NHS guidelines for the referral of patients with colorectal symptoms often overclassify patients as high risk but more importantly fail to identify a significant number of cancers which are wrongly identified as low-risk.

SN Selvachandran, David Cade, and colleagues from Leighton Hospital, Crewe, UK, investigated the value of using a specific questionnaire (completed by patients) and a computer-generated risk score in order to prioritise symptoms indicative of possible colorectal disease.

2268 patients with adverse colorectal symptoms (such as rectal bleeding, increased and/or looser bowel movements) were studied. They had been referred to a colorectal specialist by their general practitioner, and completed a patient consultation questionnaire linked to a computerised record. Referrals were prioritised with a cancer risk score according to the guidelines by a senior colorectal surgeon separately for the general practitioner's letter and for the questionnaire. A weighted numerical score was derived from the weighting of the main disease symptoms and symptom complexes (presence of more than one major symptom) and was calculated automatically when the questionnaire data were entered into a computer program.

95 of the 2268 patients had colorectal cancer. The average weighted numerical score was substantially higher (76.5) for patients with cancer than for patients who did not have cancer (44.5). The malignancy risk score derived from the patient consultation questionnaire and the weighted numerical score, whilst having a good cancer pickup, resul
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Lancet
15-Jul-2002