13 Jul Risk tool helps GPs spot and refer serious bowel conditions
The symptoms of a serious bowel condition, such as cancer, can sometimes be similar to a non-serious condition such as Irritable Bowel Syndrome (IBS) leaving GPs unsure how to act. A new risk assessment tool has therefore been developed and published in March this year to help GP’s decide who needs a specialist referral for further testing and who needs to be monitored.
Increased risk of bowel conditions in young people
Bowel cancer is significantly more common in people over 50. However, over 2,500 under 50’s are diagnosed each year with this disease, which represents a 45% rise since 2004.
The stage of diagnosis is highly important for the success of treatment when it comes to bowel cancer. If the disease is detected in Stage 1, there is typically a 98% chance of survival, according to statistics by Bowel Cancer UK. This reduces to below 10% when a patient is diagnosed at Stage 4.
A current lack of early diagnosis in young people means that 3 in 5 under 50’s are only diagnosed with bowel cancer at stage 3 or 4.
Approximately, one third will be diagnosed only when it becomes an emergency, so in A&E for example, when the chances of survival are significantly reduced.
Inflammatory bowel diseases (IBD, such as Crohn’s disease and ulcerative colitis are also increasing for all age groups, including your people. With 13,000 people being diagnosed each year, it is also a serious health concern.
Symptoms of bowel cancer
Symptoms such as those experienced with bowel cancer, IBD and also IBS account for 1 in 12 GP appointments.
Therefore, GP’s have historically struggled to highlight those patients that have IBS or another digestive disorder, with those that could be suffering with a serious bowel condition, like cancer.
Naturally, most cases won’t relate to cancer, however for the small percentage that do it is important that they are correctly identified.
Symptoms of bowel cancer can include:
- Change in bowel habit
- Loose bowel movements or diarrhoea
- Passing blood
- Abdominal pain
- A low blood count or anaemia
- Shortness of breath or excessive tiredness, linked to anaemia
- A history of colon polyps
- A family history of bowel cancer
- No symptoms
How GPs can now better diagnose and refer
In March 2017, a new risk assessment tool was published by Bowel Cancer UK and leading UK universities, to assist GP’s in identifying the symptoms of a serious bowel condition such as bowel cancer or IBD.
The tool helps GPs decide if the patient needs to be referred for more advanced tests, or if their symptoms need to be monitored instead.
The assessment uses the following to create a risk score:
- Understanding of the patient’s symptoms
- Physical examination
- Blood test results
The risk score, given as a percentage, indicates also the practical steps the GP needs to take to ensure all options have been explored:
- 3%+ risk score – An urgent referral is required to a specialist for a colonoscopy, which will inspect the bowel for signs of cancer or another serious bowel condition
- 1-3% risk score – A faecal calprotectin test is required to look for bowel inflammation and also to eliminate other conditions such as IBS.
- Under 1% risk score – Symptoms should be monitored but further testing isn’t required at this stage.
FOR HELP AND GUIDANCE ON DIGESTIVE DISORDERS AND TREATMENT FROM AN EXPERIENCED GASTROENTEROLOGIST, CONTACT DR ANTON BUNGAY.