New assessment tool for bowel cancer risk in younger patients

A RISK assessment tool to support GPs in identifying serious bowel conditions, including cancer, in patients under age 50 has been published in the British Journal of General Practice.

The assessment tool calculates risk associated with bowel symptoms and helps GPs to decide whether further tests are needed in younger patients, who may often experience significant delays in diagnosis.

Researchers at The University of Exeter, Durham University and North Tees and Hartlepool NHS Foundation Trust developed the tool in conjunction with new research into bowel conditions in age under-50 patients, and it has been published ahead of Bowel Cancer Awareness Month in April.

Over 2,500 under-50s are diagnosed with bowel cancer in the UK every year which represents a 45 per cent increase since 2004. Over 13,000 people are diagnosed with inflammatory bowel disease and many are under 50. Both of these diagnoses are increasing worldwide, including in the UK.

Bowel symptoms are common and account for one in 12 GP appointments but it can be difficult for GPs to determine which patients need further tests for possible cancer, and thus young patients often face a delay in diagnosis and a reduced chance of survival.

Five-year survival for stage 1 bowel cancer is around 98 per cent compared with less than one in ten people diagnosed at stage 4. Bowel Cancer UK research shows that nationally, three out of five people diagnosed under the age of 50 will be at stages 3 or 4, with a third (34 per cent) being diagnosed in an emergency situation, such as in A&E.

The bowel cancer and inflammatory bowel disease risk assessment tool uses symptoms, a physical examination and blood test results to calculate the risk of serious disease, as well as suggesting next steps.

Willie Hamilton, Professor of Primary Care Diagnostics at the University of Exeter Medical School, who led the research says: "The risk assessment tool should be used as a reminder to GPs to consider the likelihood of an individual patient having a serious bowel condition given the symptom or combination of symptoms they present with. The tool does not replace clinical judgement but provides more information to base a referral decision."

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