The value of colonoscopy to assess rectal bleeding in patients referred from Primary Care Units

Sánchez, Ariadna; Muñoz, Concepción; Bujanda, Luís; Iriondo, Carmen; Gil-Molet, A.; Cosme, Ángel; Sarasqueta, Cristina; Echenique-Elizondo, Miguel

doi:10.4321/s1130-01082005001200003

Cited by 10 publications

(7 citation statements)

References 16 publications

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“…Sufficient data to calculate PPVs for rectal bleeding were available in 13 papers with 18 634 participants. 11,12,14,[17][18][19][20][21][22][23][24][25][26] This is displayed as a Forest plot ( Figure 1A). The PPV ranged from 2.2% 18 to 15.8%.…”

Section: Rectal Bleedingmentioning

confidence: 99%

“…Six studies from five papers 20,[23][24][25][26] reported this symptom pair, 19,[21][22][23][24] with a total of 1466 evaluated participants. The pooled sensitivity was low, with no inconsistency between studies.…”

Section: Rectal Bleedingmentioning

confidence: 99%

“…11 A subgroup analysis of five studies with data from 887 patients over 50 years of age ( Figure 1B) provided a pooled estimate of 8.1% (95% confidence interval [CI] = 6.0 to 10.8), with moderate inconsistency between studies (I 2 = 31%, P = 0.21). 17,21,[24][25][26] Data were pooled in three studies of rectal bleeding with 46 164 patients. 11,27,28 However, a large degree of inconsistency (I 2 >96.0%, P<0.001) was present (Table 1).…”

Section: Rectal Bleedingmentioning

confidence: 99%

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The diagnostic value of symptoms for colorectal cancer in primary care: a systematic review

Astin¹,

Griffin²,

Neal³

et al. 2011

Br J Gen Pract

213

176

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BackgroundOver 37 000 new colorectal cancers are diagnosed in the UK each year. Most present symptomatically to primary care. AimTo conduct a systematic review of the diagnostic value of symptoms associated with colorectal cancer. DesignSystematic review. MethodMEDLINE, Embase, Cochrane Library, and CINAHL were searched to February 2010, for diagnostic studies of symptomatic adult patients in primary care. Studies of asymptomatic patients, screening, referred populations, or patients with colorectal cancer recurrences, or with fewer than 100 participants were excluded. The target condition was colorectal cancer. Data were extracted to estimate the diagnostic performance of each symptom or pair of symptoms. Data were pooled in a meta-analysis. The quality of studies was assessed with the QUADAS tool. ResultsTwenty-three studies were included. Positive predictive values (PPVs) for rectal bleeding from 13 papers ranged from 2.2% to 16%, with a pooled estimate of 8.1% (95% confidence interval [CI] = 6.0% to 11%) in those aged ≥50 years. Pooled PPV estimates for other symptoms were: abdominal pain (three studies) 3.3% (95% CI = 0.7% to 16%); and anaemia (four studies) 9.7% (95% CI = 3.5% to 27%). For rectal bleeding accompanied by weight loss or change in bowel habit, pooled positive likelihood ratios (PLRs) were 1.9 (95% CI = 1.3 to 2.8) and 1.8 (95% CI = 1.3 to 2.5) respectively, suggesting higher risk when both symptoms were present. Conversely, the PLR was one or less for abdominal pain, diarrhoea, or constipation accompanying rectal bleeding. ConclusionThe findings suggest that investigation of rectal bleeding or anaemia in primary care patients is warranted, irrespective of whether other symptoms are present. The risks from other single symptoms are lower, though multiple symptoms also warrant investigation.

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Section: Rectal Bleedingmentioning

confidence: 99%

Section: Rectal Bleedingmentioning

confidence: 99%

Section: Rectal Bleedingmentioning

confidence: 99%

See 1 more Smart Citation

The diagnostic value of symptoms for colorectal cancer in primary care: a systematic review

Astin¹,

Griffin²,

Neal³

et al. 2011

Br J Gen Pract

213

176

View full text Add to dashboard Cite

show abstract

“…En nuestro trabajo la mayoría de los pacientes eran mayores de 70 años y presentaban comorbilidad aunque, a diferencia de lo descrito en la literatura en nuestra serie la prevalencia fue similar en ambos sexos. La etiología más frecuente de HDB en ambos grupos fueron los divertículos cólicos en concordancia con estudios previos (4)(5)(6)12,19) pero encontramos que las neoplasias y no las angiodisplasias fueron la segunda causa más frecuente al contrario que lo que describen otros autores (2,4,8).…”

Section: Discussionunclassified

Dificultades y controversias en el manejo hospitalario de la hemorragia digestiva baja

Martin

Trapero-Marugán

Perona

et al. 2008

Rev. esp. enferm. dig.

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“…El VPP de la rectorragia para CCR es inferior al 1% en población general, oscila entre el 2-15% en las consultas de AP, y alcanza el 40% en las consultas de AE [73][74][75][76] . Datos obtenidos en nuestro entorno muestran resultados similares 77,78 . [Estudios de diagnóstico (2b)] La presencia de signos y síntomas asociados modifican el VPP de la rectorragia 75,76 .…”

Section: Manifestaciones Clínicasunclassified

Guia de Practica Clinica. Prevencion del Cancer Colorrectal. Actualizacion 2009

2009

Gastroenterología y Hepatología

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The value of colonoscopy to assess rectal bleeding in patients referred from Primary Care Units

Cited by 10 publications

References 16 publications

The diagnostic value of symptoms for colorectal cancer in primary care: a systematic review

The diagnostic value of symptoms for colorectal cancer in primary care: a systematic review

Dificultades y controversias en el manejo hospitalario de la hemorragia digestiva baja

Guia de Practica Clinica. Prevencion del Cancer Colorrectal. Actualizacion 2009

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