Introduction When attending the bowel cancer screening (BSC) programme patients undergo pre-colonoscopy assessment of their symptoms. This is conducted by the specialist screening practitioner for the BCS programme. Following a diagnosis of bowel cancer at colonoscopy the questions were asked again, after a 3–6 month period. Comparison could then be made to assess the validity of the pre-assessment questionnaire. It would also allow us to look at whether patients reported all symptoms during pre-assessment.
Methods All patients with a diagnosis of bowel cancer, at the Cheshire Bowel Cancer Screening Programme, were asked to complete a second symptom assessment questionnaire. A direct comparison between the reported symptoms pre and post colonoscopy could then be made. The post colonoscopy questioning also included duration of symptoms.
Results In total 83 patients replied to the second questionnaire. The symptoms reported pre and post colonoscopy were similar. PR bleeding was the most commonly reported symptom in the pre and post assessment questionnaire. 42 (49%) patients reported this in the pre questioning, whilst 31 reported in after their diagnostic procedure. The next most common symptom was change in bowel habit. The number of patients reporting this was the same in both the pre and post assessment (n = 25). Further symptoms were assessed in the post procedure questionnaire, 19% and 14% of patients report straining and abdominal bloating respectively. There was also an increase in the reporting of family history of malignancy in the post assessment process, namely of Breast and Ovarian carcinoma. 30% of patients with diagnosed bowel cancer reported a family history of bowel cancer during the pre and post assessment questionnaire. Only 11% patients reported both a family history of bowel cancer and PR bleeding during pre-assessment. When comparing multiple symptoms the results in the two assessments were fairly similar. 16 patients in the pre-assessment reported both bleeding and change in bowel habit, with 14 in the post assessment group.
Table showing numbers of patients reporting combinations of symptoms, pre and post assessments.
Conclusion PR bleeding is the most reported symptom in those found to have bowel cancer. However, more than 50% patients with diagnosed bowel cancer did not report PR bleeding. When combining all symptoms together we found that 23% patients were totally asymptomatic. Comparison of questionnaires collected prior and post colonoscopy on bowel cancer screening programme has shown accurate and consistent reporting of symptoms.
Disclosure of Interest None Declared
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