Alarm symp­toms missed in bowel cancer emer­gency pa­tients

Malta Independent - - HEALTH -

One in five bowel cancer pa­tients di­ag­nosed in an emer­gency had “red flag” symp­toms that should have been picked up ear­lier, a study in the Bri­tish Jour­nal of Cancer sug­gests.

And 16% of emer­gency bowel cancer pa­tients had seen their GP three times or more with rel­e­vant symp­toms.

Over­all, these symp­toms were less com­mon in pa­tients di­ag­nosed at an emer­gency stage rather than ear­lier on.

The study looked at data on di­ag­noses in Eng­land from 2005 to 2006.

The re­searchers, from Univer­sity Col­lege London and the London School of Hy­giene and Trop­i­cal Medicine, fo­cused on what had hap­pened to pa­tients in the five years lead­ing up to their cancer di­ag­no­sis.

They an­a­lysed Na­tional Cancer Reg­istry data that was linked to GP data for 1,606 pa­tients from more than 200 GP prac­tices.

They found that in Eng­land 35% of colon can­cers and 15% of rec­tal can­cers were di­ag­nosed af­ter an emer­gency pre­sen­ta­tion.

Although many of these pa­tients of­ten did not dis­play ob­vi­ous symp­toms for bowel cancer, mak­ing it harder for GPs to di­ag­nose their cancer early, 17.5% of colon cancer pa­tients and 23% of rec­tal cancer pa­tients did have “red flag” symp­toms.

These symp­toms in­clude rec­tal bleed­ing or blood in the stools, a change in bowel habit and stom­ach pain.

The re­searchers say these fig­ures in­di­cate there could have been op­por­tu­ni­ties to pick up the dis­ease ear­lier.

Most pa­tients, re­gard­less of how they were di­ag­nosed, vis­ited their doc­tor in the year be­fore their di­ag­no­sis.

And pa­tients tended to see their doc­tors more of­ten in the months and days lead­ing up to their cancer di­ag­no­sis - whether it hap­pened in an emer­gency or not.

The re­search team sug­gested that spe­cially trained nurses could sup­port GPs and act as a safety net dur­ing con­sul­ta­tions.

Eas­ier ac­cess to spe­cial­ist ad­vice for GPs was also im­por­tant, the study said.

Cristina Renzi, lead re­searcher from Univer­sity Col­lege London, said pa­tients di­ag­nosed with cancer af­ter an emer­gency pre­sen­ta­tion did not fare as well as pa­tients di­ag­nosed by their GP.

“How­ever, in most cases they visit their doc­tor for var­i­ous rea­sons mul­ti­ple times dur­ing the months lead­ing up to their di­ag­no­sis, which could rep­re­sent op­por­tu­ni­ties to di­ag­nose the cancer ear­lier.

She added: “It’s im­por­tant to find ways to en­sure these pa­tients can be di­ag­nosed at an early stage.

“And this study high­lights the need to sup­port GPs and give them the tools to di­ag­nose and re­fer pa­tients promptly when they feel it’s nec­es­sary.”

Dr Julie Sharp, head of pa­tient in­for­ma­tion and health at Cancer Re­search UK, said di­ag­nos­ing pa­tients who were not show­ing typ­i­cal symp­toms of bowel cancer was very dif­fi­cult.

“So re­search like this, to un­der­stand more about peo­ple’s symp­tom his­to­ries, is cru­cial to find bet­ter ways to di­ag­nose the dis­ease at an early stage, when treat­ment is more likely to be suc­cess­ful.”

Most com­mon symp­toms dur­ing year be­fore di­ag­no­sis among colon cancer pa­tients:

• ab­dom­i­nal pain

• anaemia

• di­ar­rhoea

• rec­tal bleed­ing

Among rec­tal cancer pa­tients:

• rec­tal bleed­ing

• change in bowel habits

• di­ar­rhoea

• ab­dom­i­nal pain

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