Title
Symptomatology of colorectal cancer and polyps: A prospective cohort study
Author
Dr Benjamin Julien
BMed, MTrauma
General Surgery Registrar
John Hunter Hospital, Newcastle, New South Wales, Australia
Purpose
The symptoms of bowel malignancy have been well established but there is little data as to the symptoms of colonic polyps and whether the two overlap. The aim of this study was to identify whether the commonly held symptoms of adenocarcinoma are present in those with polyp disease and if so whether this is related to the extent of the polyps.
Methodology
A prospective cohort study was undertaken in Newcastle, Australia. Patients aged 50 to 74 years old with a positive faecal occult blood test and deemed suitable for a colonoscopy by specialist were eligible for participation. Following selection, 2967 participants were interviewed over telephone and information regarding symptoms and risk factors of colorectal cancer was recorded. Following colonoscopy data was recorded including histopathology, polyp size and number of biopsies.
Results
A total of 2967 patients underwent colonoscopy following positive FOBT. A total of 995 (33.53%) subjects reported macroscopic per rectal bleeding, 545 (18.36%) a change in bowel habit and 381 (12.84%) abdominal pain. Subgroup analysis showed that patients diagnosed with adenocarcinoma (93, 3.13%) were significantly more likely to be symptomatic across all domains. As a group, patients with polyps did not demonstrate increased prevalence of symptoms. Sub-group analysis of polyp disease severity did not reach statistical significance.
Conclusion
This study suggests that commonly held symptoms of adenocarcinoma are not present at an increased rate in patients with polyp disease. Future research attempting to identify symptoms unique to colonic polyps may aid in the identification of colorectal neoplasia before it has become malignant.