[Rectal hemorrhage. Colorectal cancer and polyps in patients aged 40 and over seeking consultation]

The objective was to determine the frequency of neoplastic conditions in patients presenting in general practice with rectal bleeding and to explain the associations between presenting symptoms and final diagnoses. We conducted two studies in which we invited Danish general practitioners to register three to four patients aged 40 and over presenting with rectal bleeding. In study 1 among 208 patients aged 40 and over and presenting with a first episode of rectal bleeding, colorectal cancer and polyps were present in 15.4 and 7.7%, respectively. In study 2 among 209 patients aged 40 and over and presenting with overt rectal bleeding, 156 reported it as either the first bleeding episode or a change in their usual bleeding pattern, and in this group colorectal cancer and polyps were diagnosed in 14.1 and 11.5% respectively. A joint analysis of the two study populations showed that only age and change in bowel habits contributed to differentiating the cancer from the non-cancer patients.