Gastroenterology  |  Colorectal Cancer Pathway - Signs and Symptoms


Colorectal Cancer Pathway - Signs and Symptoms

1. Change in bowel habit:

   Is defined as change to loose stools and/or increased frequency of defaecation persisting for 6 weeks or more (NICE)

2. Rectal bleeding without anal symptoms:

    >40  yrs

Not outlet type (Outlet bleeding is defined as bleeding that occurs on defaecation or after, and appears on the paper, may drip into the pan, is usually bright red, and is not mixed in with the stools. There may be associated anal pain, stinging or discomfort.)

3.  Unexplained weight loss:

    >5 kg

    NB: weight loss as a lone symptom does not have a high pick-up rate

4.. Abdominal pain, mass or tenderness- thought to be of colonic origin:

    NB: pain as a lone symptom does not have a high pick-up rate

5. Abnormal PR examination:

    Palpable intraluminal rectal mass

6. Iron deficiency anaemia

As demonstarted by a low ferritin. Iron studies are not reliable.

   Hb<110 in men

   Hb< 100 in non-menstruating women or unexplained drop of >30g/dL

NB:  A ferritin >100, even in the presence of inflammation excludes iron deficiency.  A normal ferritin <100 can be consistent with iron deficiency in the presence inflammation (raised CRP or ESR)


Last updated : Friday, August 21, 2015
Next review date : Saturday, August 20,2016

Disclaimer: This site is intended to be flexible and frequently updated. While every effort has been made to ensure accuracy, all information should be verified.