Risk in primary care of colorectal cancer from new onset rectal bleeding: 10 year prospective study

doi:10.1136/bmj.38846.684850.2F

BMJ 2006;333:69-70 (8 July), doi:10.1136/bmj.38846.684850.2F (published 21 June 2006)

Research

Risk in primary care of colorectal cancer from new onset rectal bleeding: 10 year prospective study

Jennifer du Toit, general practitioner¹, William Hamilton, senior research fellow², Kevin Barraclough, general practitioner¹

¹ Hoyland House, Painswick, Gloucestershire GL6 6RD, ² Academic Unit of Primary Health Care, Department of Community Based Medicine, University of Bristol, Bristol BS8 1AU

Correspondence to: J du Toit kbarraclough{at}ehotspot.co.uk

Abstract

Objective To measure the risk of colorectal cancer and adenomawith new onset rectal bleeding reported to primary care.

Design Cohort study.

Setting A rural general practice in the United Kingdom.

Participants Patients aged 45 or more with new onset rectalbleeding, irrespective of other symptoms.

Main outcome measures Percentage of participants in whom colorectalcancer or colonic adenoma was identified after investigationof the bowel.

Results During a 10 year period, 265 patients reported new rectalbleeding. Of these, 15 (5.7%, 95% confidence interval 3.2% to9.2%) had colorectal cancer, and 13 (4.9%, 2.6% to 8.4%) hadcolonic adenoma. Only two of the patients with cancer had haddiarrhoea.

Conclusions One in 10 patients aged 45 or more with new onsetrectal bleeding had colonic neoplasia, so investigation of thebowel should be offered to all such patients, whether or notthey have other symptoms.

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