Predictive values of colorectal cancer alarm symptoms in the general population

a nationwide cohort study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

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.

OriginalsprogEngelsk
TidsskriftB J C
Vol/bind120
Udgave nummer6
Sider (fra-til)595-600
ISSN0007-0920
DOI
StatusUdgivet - mar. 2019

Fingeraftryk

Colorectal Neoplasms
Cohort Studies
Population
Delivery of Health Care
Early Detection of Cancer
Registries
Neoplasms
Referral and Consultation
Age Groups
Guidelines
Incidence

Citer dette

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title = "Predictive values of colorectal cancer alarm symptoms in the general population: a nationwide cohort study",
abstract = "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.",
author = "Sanne Rasmussen and Peter Haastrup and Kirubakaran Balasubramaniam and Sandra Elnegaard and Christensen, {Ren{\'e} dePont} and Storsveen, {Maria Munch} and Jens S{\o}ndergaard and Jarb{\o}l, {Dorte Ejg}",
year = "2019",
month = "3",
doi = "10.1038/s41416-019-0385-x",
language = "English",
volume = "120",
pages = "595--600",
journal = "B J C",
issn = "0007-0920",
publisher = "Nature Publishing Group",
number = "6",

}

TY - JOUR

T1 - Predictive values of colorectal cancer alarm symptoms in the general population

T2 - a nationwide cohort study

AU - Rasmussen, Sanne

AU - Haastrup, Peter

AU - Balasubramaniam, Kirubakaran

AU - Elnegaard, Sandra

AU - Christensen, René dePont

AU - Storsveen, Maria Munch

AU - Søndergaard, Jens

AU - Jarbøl, Dorte Ejg

PY - 2019/3

Y1 - 2019/3

N2 - 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.

AB - 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.

U2 - 10.1038/s41416-019-0385-x

DO - 10.1038/s41416-019-0385-x

M3 - Journal article

VL - 120

SP - 595

EP - 600

JO - B J C

JF - B J C

SN - 0007-0920

IS - 6

ER -