Lower gastrointestinal symptoms are prevalent among individuals colonoscoped within the Bowel Cancer Screening Programme.

Abstract

The National Health Service Bowel Cancer Screening Programme (BCSP) aims to detect earlier stage cancer in asymptomatic individuals. Early experience suggested that many participants had lower gastrointestinal symptoms before screening. The study evaluated the prevalence of lower gastrointestinal symptoms and consultation behaviour among individuals undergoing colonoscopy at the South of Tyne BCSP Centre. Data were collected on all undergoing clinic assessment and colonoscopy. Symptoms were categorized as altered bowel habit (ABH), rectal bleeding (RB), abdominal pain (AP) and unexplained weight loss (UWL). Symptoms were present in 65.1% (492/756) of subjects, 64.4% (431/669) of those with a non-cancer diagnosis and 70.1% (61/87) of those with cancer. Among those with a non-cancer diagnosis, symptoms were ABH in 52% (224/431), RB in 81.4% (351/431), AP in 15.3% (66/431) and UWL in 3.0% (13/431). In those with cancer symptoms they were ABH in 33.3% (29/87), RB in 55.2% (48/87) and AP in 11.5% (10/87). There was no significant difference in the prevalence of symptoms in those with a cancer or non-cancer diagnosis. A total of 34.2% (157/459) of individuals with symptoms had consulted their general practitioner, 28.1% (16/57) of those with cancer and 35.1% (141/402) without. A large proportion of individuals colonoscoped in the BCSP reported symptoms predating screening. Their prevalence did not differ significantly between cancer and non-cancer diagnoses. The majority had not consulted their general practitioner. Health promotion regarding the importance of lower gastrointestinal symptoms and a risk assessment tool to help select those needing urgent specialist assessment are required.