Imperial College London
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MissEmmaRobbins

Faculty of Medicine, Department of Surgery & Cancer

Research Postgraduate
 
 
 
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Contact

 

e.robbins

 
 
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Location

 

Room 1089Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Cross:2019:10.1038/s41416-018-0335-z,
author = {Cross, A and Wooldrage, K and Robbins, E and Pack, K and Brown, JP and Hamilton, W and Thompson, MR and Flashman, KG and Halligan, S and Thomas-Gibson, S and Vance, M and Saunders, BP and Atkin, W},
doi = {10.1038/s41416-018-0335-z},
journal = {British Journal of Cancer},
pages = {154--164},
title = {Whole colon investigation versus flexible sigmoidoscopy for suspected colorectal cancer based on presenting symptoms and signs: a multicentre cohort study},
url = {http://dx.doi.org/10.1038/s41416-018-0335-z},
volume = {120},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundPatients with suspected colorectal cancer (CRC) usually undergo colonoscopy. Flexible sigmoidoscopy (FS) may be preferred if proximal cancer risk is low. We investigated which patients could undergo FS alone.MethodsCohort study of 7375 patients (≥55 years) referred with suspected CRC to 21 English hospitals (2004–2007), followed using hospital records and cancer registries. We calculated yields and number of needed whole-colon examinations (NNE) to diagnose one cancer by symptoms/signs and subsite. We considered narrow (haemoglobin <11 g/dL men; <10 g/dL women) and broad (<13 g/dL men; <12 g/dL women) anaemia definitions and iron-deficiency anaemia (IDA).ResultsOne hundred and twenty-seven proximal and 429 distal CRCs were diagnosed. A broad anaemia definition identified 80% of proximal cancers; a narrow definition with IDA identified 39%. In patients with broad definition anaemia and/or abdominal mass, proximal cancer yield and NNE were 4.8% (97/2022) and 21. In patients without broad definition anaemia and/or abdominal mass, with rectal bleeding or increased stool frequency (41% of cohort), proximal cancer yield and NNE were 0.4% (13/3031) and 234.ConclusionMost proximal cancers are accompanied by broad definition anaemia. In patients without broad definition anaemia and/or abdominal mass, with rectal bleeding or increased stool frequency, proximal cancer is rare and FS should suffice.
AU  - Cross,A
AU  - Wooldrage,K
AU  - Robbins,E
AU  - Pack,K
AU  - Brown,JP
AU  - Hamilton,W
AU  - Thompson,MR
AU  - Flashman,KG
AU  - Halligan,S
AU  - Thomas-Gibson,S
AU  - Vance,M
AU  - Saunders,BP
AU  - Atkin,W
DO  - 10.1038/s41416-018-0335-z
EP  - 164
PY  - 2019///
SN  - 0007-0920
SP  - 154
TI  - Whole colon investigation versus flexible sigmoidoscopy for suspected colorectal cancer based on presenting symptoms and signs: a multicentre cohort study
T2  - British Journal of Cancer
UR  - http://dx.doi.org/10.1038/s41416-018-0335-z
UR  - http://hdl.handle.net/10044/1/65582
VL  - 120
ER  -
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