Are screen detected colorectal cancers asymptomatic?

Area of Science:

• Gastroenterology
• Oncology
• Public Health

Background:

• Colorectal cancer (CRC) screening aims to detect asymptomatic disease for early intervention.
• The National Bowel Cancer Screening Programme (NHS NBCSP) pilots aim to improve CRC detection rates.

Purpose of the Study:

• To assess the prevalence of significant symptoms in patients diagnosed with CRC through NHS NBCSP pilots.
• To understand the symptom profile of screening-detected colorectal cancer.

Main Methods:

• Retrospective analysis of data from the English arm of the NHS NBCSP pilots.
• Patients with positive faecal occult blood tests completed a symptomatology questionnaire before colonoscopy.

Main Results:

• 200 patients were diagnosed with colorectal cancer (CRC).
• 81.5% of patients reported gastrointestinal (GI) symptoms.
• Significant symptoms included rectal bleeding (47.7%), change in bowel habit (24%), tenesmus (36.5%), and peri-anal discomfort (15.5%).

Conclusions:

• A high prevalence of significant symptoms exists in screening-detected CRC cases.
• Increased public and physician awareness of CRC symptoms may lead to earlier presentation via routine services.