Introduction Studies have reported a high prevalence of lower gastrointestinal (LGI) symptoms in bowel cancer screening (BCSP) patients. However, symptoms are often vague and without characterisation their significance is unclear. This study investigates the prevalence and characteristics of lower gastrointestinal symptoms in screening patients and aims to determine the relevance of two week wait (2ww) symptoms in this cohort.
Methods A prospective cohort study was performed. BCSP patients presenting for colonoscopy over a 7-month period were included. Data on symptom prevalence, frequency and duration was collected and assessed against 2-week wait criteria. Associations between symptom prevalence and outcome were investigated using the two-tailed χ2 test.
Results Symptom and outcome data was collected in 397 patients. LGI symptoms were reported by 282 (71%) patients and 37 patients (9%) were found to have colorectal cancer (CRC). Symptom prevalence was comparable between those with or without CRC (65% vs.72%, p = 0.473). Meanwhile, 2ww symptoms were reported in 148 (37%) of all patients. 2ww symptom prevalence was comparable in those with and without cancer (38% vs. 39%, p = 0.915).
Conclusion This study demonstrates that while 2ww symptoms are highly prevalent in a FOB positive cohort, they do not predict a finding of colorectal cancer. These findings suggest that 2ww symptoms could not be used to prioritise investigation in this cohort while in those patients referred with 2ww symptoms, additional FOB testing would offer little predictive utility. Further efforts to increase public awareness of cancer symptoms are required, whilst false reassurance from a negative result should be discouraged.
Disclosure of Interest None Declared.