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Two‐week wait symptoms are prevalent in screened patients with a positive faecal occult blood test but do not predict cancer
Author(s) -
VaughanShaw P. G.,
Cutting J.,
Borley N.,
Brooklyn T.,
Wheeler J. M. D.
Publication year - 2014
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12422
Subject(s) - medicine , colorectal cancer , colonoscopy , cancer , prospective cohort study , irritable bowel syndrome , cohort , gastroenterology
Aim Lower gastrointestinal ( LGI ) symptoms are prevalent in patients screened for bowel cancer yet do not predict a finding of cancer. This study evaluates symptoms in patients with these characteristics against the 2‐week wait (2ww) criteria to determine whether they predicted cancer in these patients. Method A prospective cohort study was performed. Patients with a positive faecal occult blood ( FOB ) test attending our unit over a 7‐month period were included. Data on symptom prevalence, frequency and duration were collected and assessed against the 2ww criteria. Associations between symptom prevalence and patient outcome were investigated using the χ 2 test. Results Three hundred and ninety‐seven patients were included and 37 (9%) were found to have colorectal cancer ( CRC ). The prevalence of undefined LGI symptoms was 71% and appeared comparable between those with and without CRC (65 vs 72%, P = 0.385). 2ww symptoms were reported in 147 (37%), with 2ww change in bowel habit in 10% and 2ww rectal bleeding in 31%. 2ww symptom prevalence was similar in those with and without cancer (38 vs 37%, P = 0.915). No significant differences in overall 2ww prevalence or prevalence of individual 2ww symptoms were demonstrated between those with a normal colonoscopy or one showing cancer, polyps or other pathology. Twenty nine per cent of patients with 2ww symptoms had reported these to their GP . Conclusion Undefined LGI symptoms are prevalent in FOB ‐positive patients but do not predict CRC . 2ww symptoms are also highly prevalent, yet similarly fail to predict cancer. Further efforts to increase public awareness of cancer symptoms are required, whilst false reassurance from a negative FOB result should be discouraged.