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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1992 Jun;46(3):241–244. doi: 10.1136/jech.46.3.241

Delay in consulting a medical practitioner about rectal bleeding.

J E Byles 1, S Redman 1, D Hennrikus 1, R W Sanson-Fisher 1, J Dickinson 1
PMCID: PMC1059560  PMID: 1645079

Abstract

STUDY OBJECTIVE--The aims were to estimate the incidence of rectal bleeding in the community, and to determine the proportion of individuals who delay or fail to seek medical advice after a first episode of rectal bleeding. DESIGN--The data were collected as part of a large scale general population survey of the health practices and attitudes of individuals in a randomly selected sample of 2121 households. SETTING--The survey was conducted in the Newcastle and Lake Macquarie areas of New South Wales, Australia, during 1987-88. PARTICIPANTS--Information about rectal bleeding was collected from 1213 individuals aged 40 years and over. MEASUREMENTS AND MAIN RESULTS--Of the 1213 people aged 40 years and over, 239 (20%) reported noticing rectal bleeding at some time in their life. However, since an estimated 4.5% had noticed rectal bleeding for the first time in the past year the true lifetime incidence of rectal bleeding is likely to be much higher. Of the 77 individuals who had noticed a first occurrence of rectal bleeding more than three months but less than five years prior to the interview, 23 (30%) had either not sought medical advice or had only done so after a period of delay. The most commonly reported reason for delay or failure to consult was thinking that the bleeding was not serious and would clear up by itself. CONCLUSIONS--The data suggest that prompt investigation of rectal bleeding is not occurring in a relatively large proportion of cases. However, in the absence of firm evidence that early detection improves prognosis, and considering the costs of screening, it would be premature to initiate programmes which encourage people to seek care promptly for this symptom.

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Selected References

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  1. Berkanovic E. Seeking care for cancer relevant symptoms. J Chronic Dis. 1982;35(9):727–734. doi: 10.1016/0021-9681(82)90096-0. [DOI] [PubMed] [Google Scholar]
  2. Chapuis P. H., Goulston K. J., Dent O. F., Tait A. D. Predictive value of rectal bleeding in screening for rectal and sigmoid polyps. Br Med J (Clin Res Ed) 1985 May 25;290(6481):1546–1548. doi: 10.1136/bmj.290.6481.1546. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Dent O. F., Chapuis P. H., Goulston K. J. Relationship of survival to stage of the tumour and duration of symptoms in colorectal cancer. Med J Aust. 1983 Mar 19;1(6):274–275. doi: 10.5694/j.1326-5377.1983.tb136077.x. [DOI] [PubMed] [Google Scholar]
  4. Dent O. F., Goulston K. J., Zubrzycki J., Chapuis P. H. Bowel symptoms in an apparently well population. Dis Colon Rectum. 1986 Apr;29(4):243–247. doi: 10.1007/BF02553027. [DOI] [PubMed] [Google Scholar]
  5. Farrands P. A., Hardcastle J. D., Chamberlain J., Moss S. Factors affecting compliance with screening for colorectal cancer. Community Med. 1984 Feb;6(1):12–19. [PubMed] [Google Scholar]
  6. Farrands P. A., Hardcastle J. D. Colorectal screening by a self-completion questionnaire. Gut. 1984 May;25(5):445–447. doi: 10.1136/gut.25.5.445. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Goulston K. J., Cook I., Dent O. F. How important is rectal bleeding in the diagnosis of bowel cancer and polyps? Lancet. 1986 Aug 2;2(8501):261–265. doi: 10.1016/s0140-6736(86)92081-7. [DOI] [PubMed] [Google Scholar]
  8. Goulston K., Chapuis P., Dent O., Bokey L. Significance of bowel symptoms. Med J Aust. 1987 Jun 15;146(12):631–633. doi: 10.5694/j.1326-5377.1987.tb120441.x. [DOI] [PubMed] [Google Scholar]
  9. Hackett T. P., Cassem N. H., Raker J. W. Patient delay in cancer. N Engl J Med. 1973 Jul 5;289(1):14–20. doi: 10.1056/NEJM197307052890104. [DOI] [PubMed] [Google Scholar]
  10. Holliday H. W., Hardcastle J. D. Delay in diagnosis and treatment of symptomatic colorectal cancer. Lancet. 1979 Feb 10;1(8111):309–311. doi: 10.1016/s0140-6736(79)90718-9. [DOI] [PubMed] [Google Scholar]
  11. Silman A. J., Mitchell P., Nicholls R. J., Macrae F. A., Leicester R. J., Bartram C. I., Simmons M. J., Campbell P. D., Hearn C. E., Constable P. J. Self-reported dark red bleeding as a marker comparable with occult blood testing in screening for large bowel neoplasms. Br J Surg. 1983 Dec;70(12):721–724. doi: 10.1002/bjs.1800701209. [DOI] [PubMed] [Google Scholar]

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