Straightforward assessment to improve identification of people at high risk from colorectal cancer

July 15, 2002

Authors of a UK study published on THE LANCET's website today -- -- highlight a straightforward scoring method which could predict colorectal cancers more reliably than current UK NHS guidelines.

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, resulted in fewer patients being identified at high risk (around 40%) compared with a 50% high-risk grading for the current NHS guidelines. The new system identified a further 13% of cancer patients who would have been categorised as low risk by the current NHS guidelines, thus detecting nearly all cancers (99%) by investigating just over half(57%) of the patients referred.

David Cade comments: "The patient consultation questionnaire with the weighted numerical score produces an accurate system to prioritise patients with colorectal symptoms referred by their general practitioners. The questionnaire and the weighted numerical score might also have a place in general practice to help family doctors identify individuals at substantial risk of colorectal cancer."
Contact: Mr David Cade, Department of Surgery, Leighton Hospital, Crewe, Cheshire, CW1 4QJ, UK; T) +44 (0)1270 612046; F) +44 (0)1270 612046; E)


Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to