Symptom-based approach to colorectal cancer

Survey of primary care physicians in Italy

F. Panzuto, A. Chiriatti, S. Bevilacqua, P. Giovannetti, G. Russo, S. Impinna, F. Pistilli, G. Capurso, B. Annibale, Gianfranco Delle Fave, G. Albanese, N. Augenti, I. Avolio, M. Azzolini, B. Bernardini, M. Bernardini, M. Bernoni, D. Bianco, L. Bocale, F. Borghesi & 79 others G. Borgna, C. Bottini, M. Bottini, L. Brandodoro, A. Busà, F. Cagliesi, A. Calicchia, M. A. Caponi, B. Cardarelli, M. Carli, M. C. Carlomagno, G. Casola, G. Cavaliere, E. Ceccarelli, R. Cerqua, M. Cesarini, M. Cianfoni, E. Ciucci, S. Conte, A. Cottani, U. Creo, S. Dani, P. De Angelis, G. De Bonis, F. De Liggio, A. De Simone, R. De Tommasi, M. Di Roberto, D. Di Viccaro, M. Donato, C. Faggiani, G. Feola, M. Ficuccilli, F. Forleo, T. Frugeri, A. Galassi, A. Gargaro, V. Gatti, A. Gaveglia, M. Granatelli, M. Grandi, S. Grattarola, E. Grimaldi, A. M. Grisanti, N. Iacovone, V. Izzo, M. M. Jarosinska, G. Kissopoulos, R. La Paglia, M. Lauretti, A. Litta, P. Lo Prete, L. Longhi, M. Lori, R. Macrì, M. L. Madonna, E. Mammucari, M. Mancini, R. Mango, M. Marasca, A. Marchionni, G. Margotti, C. Marinaro, D. Marziale, M. Mazzilli, E. Merletti, G. Messina, L. Michelangeli, A. Milioni, C. Mingarelli, G. Montuori, A. Mormile, L. Murano, G. Mutalipassi, P. Muzzu Martis, T. Natili, G. Nicolini, A. Nigro, M. Orazietti

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background. Colorectal cancer is a frequent cause of mortality in Western countries, including Italy, where a definite screening policy has not yet been adopted. It is likely that most patients with colorectal cancer refer, first of all, to their primary care physician at onset of symptoms. Aim. To perform a survey on the approach, of primary care physicians, to patients with symptoms suggesting the presence of colorectal cancer. Methods. A total of 280 consecutive symptomatic patients without previous diagnosis of organic colon disease or recent colon investigation in whom, after consulting, 159 primary care physicians in Lazio (Italy) prescribed colonoscopy or double-contrast barium enema. Results. Most frequent presenting symptoms were lower abdominal pain (79.6%), bloating (59.6%), constipation (47.8%), diarrhoea (30.3%), iron deficiency anaemia (24.6%), change in bowel habits (20.3%) and weight loss (15%). Colonoscopy and barium enema were equally advised by physicians to rule out the presence of cancer (56% versus 44%, P = ns). Cancer was found in 14.6% of patients. Age >50 years and iron deficiency anaemia were the only independent variables associated with colorectal cancer (Odds ratios 9.0 and 8.8 at multivariate analysis, respectively). Conclusion. The symptom-based selection criteria used by primary care physicians have been shown to be scarcely effective. Colonic investigation should be requested, irrespective to the symptoms, in patients aged >50 years with iron deficiency anaemia.

Original languageEnglish
Pages (from-to)869-875
Number of pages7
JournalDigestive and Liver Disease
Volume35
Issue number12
DOIs
Publication statusPublished - Dec 2003

Fingerprint

Primary Care Physicians
Italy
Colorectal Neoplasms
Iron-Deficiency Anemias
Colonoscopy
Colon
Constipation
Abdominal Pain
Patient Selection
Habits
Weight Loss
Diarrhea
Neoplasms
Multivariate Analysis
Odds Ratio
Surveys and Questionnaires
Physicians
Mortality
Barium Enema

Keywords

  • Colorectal cancer
  • Iron deficiency anaemia
  • Primary care physicians

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Panzuto, F., Chiriatti, A., Bevilacqua, S., Giovannetti, P., Russo, G., Impinna, S., ... Orazietti, M. (2003). Symptom-based approach to colorectal cancer: Survey of primary care physicians in Italy. Digestive and Liver Disease, 35(12), 869-875. https://doi.org/10.1016/j.dld.2003.07.005

Symptom-based approach to colorectal cancer : Survey of primary care physicians in Italy. / Panzuto, F.; Chiriatti, A.; Bevilacqua, S.; Giovannetti, P.; Russo, G.; Impinna, S.; Pistilli, F.; Capurso, G.; Annibale, B.; Delle Fave, Gianfranco; Albanese, G.; Augenti, N.; Avolio, I.; Azzolini, M.; Bernardini, B.; Bernardini, M.; Bernoni, M.; Bianco, D.; Bocale, L.; Borghesi, F.; Borgna, G.; Bottini, C.; Bottini, M.; Brandodoro, L.; Busà, A.; Cagliesi, F.; Calicchia, A.; Caponi, M. A.; Cardarelli, B.; Carli, M.; Carlomagno, M. C.; Casola, G.; Cavaliere, G.; Ceccarelli, E.; Cerqua, R.; Cesarini, M.; Cianfoni, M.; Ciucci, E.; Conte, S.; Cottani, A.; Creo, U.; Dani, S.; De Angelis, P.; De Bonis, G.; De Liggio, F.; De Simone, A.; De Tommasi, R.; Di Roberto, M.; Di Viccaro, D.; Donato, M.; Faggiani, C.; Feola, G.; Ficuccilli, M.; Forleo, F.; Frugeri, T.; Galassi, A.; Gargaro, A.; Gatti, V.; Gaveglia, A.; Granatelli, M.; Grandi, M.; Grattarola, S.; Grimaldi, E.; Grisanti, A. M.; Iacovone, N.; Izzo, V.; Jarosinska, M. M.; Kissopoulos, G.; La Paglia, R.; Lauretti, M.; Litta, A.; Lo Prete, P.; Longhi, L.; Lori, M.; Macrì, R.; Madonna, M. L.; Mammucari, E.; Mancini, M.; Mango, R.; Marasca, M.; Marchionni, A.; Margotti, G.; Marinaro, C.; Marziale, D.; Mazzilli, M.; Merletti, E.; Messina, G.; Michelangeli, L.; Milioni, A.; Mingarelli, C.; Montuori, G.; Mormile, A.; Murano, L.; Mutalipassi, G.; Muzzu Martis, P.; Natili, T.; Nicolini, G.; Nigro, A.; Orazietti, M.

In: Digestive and Liver Disease, Vol. 35, No. 12, 12.2003, p. 869-875.

Research output: Contribution to journalArticle

Panzuto, F, Chiriatti, A, Bevilacqua, S, Giovannetti, P, Russo, G, Impinna, S, Pistilli, F, Capurso, G, Annibale, B, Delle Fave, G, Albanese, G, Augenti, N, Avolio, I, Azzolini, M, Bernardini, B, Bernardini, M, Bernoni, M, Bianco, D, Bocale, L, Borghesi, F, Borgna, G, Bottini, C, Bottini, M, Brandodoro, L, Busà, A, Cagliesi, F, Calicchia, A, Caponi, MA, Cardarelli, B, Carli, M, Carlomagno, MC, Casola, G, Cavaliere, G, Ceccarelli, E, Cerqua, R, Cesarini, M, Cianfoni, M, Ciucci, E, Conte, S, Cottani, A, Creo, U, Dani, S, De Angelis, P, De Bonis, G, De Liggio, F, De Simone, A, De Tommasi, R, Di Roberto, M, Di Viccaro, D, Donato, M, Faggiani, C, Feola, G, Ficuccilli, M, Forleo, F, Frugeri, T, Galassi, A, Gargaro, A, Gatti, V, Gaveglia, A, Granatelli, M, Grandi, M, Grattarola, S, Grimaldi, E, Grisanti, AM, Iacovone, N, Izzo, V, Jarosinska, MM, Kissopoulos, G, La Paglia, R, Lauretti, M, Litta, A, Lo Prete, P, Longhi, L, Lori, M, Macrì, R, Madonna, ML, Mammucari, E, Mancini, M, Mango, R, Marasca, M, Marchionni, A, Margotti, G, Marinaro, C, Marziale, D, Mazzilli, M, Merletti, E, Messina, G, Michelangeli, L, Milioni, A, Mingarelli, C, Montuori, G, Mormile, A, Murano, L, Mutalipassi, G, Muzzu Martis, P, Natili, T, Nicolini, G, Nigro, A & Orazietti, M 2003, 'Symptom-based approach to colorectal cancer: Survey of primary care physicians in Italy', Digestive and Liver Disease, vol. 35, no. 12, pp. 869-875. https://doi.org/10.1016/j.dld.2003.07.005
Panzuto F, Chiriatti A, Bevilacqua S, Giovannetti P, Russo G, Impinna S et al. Symptom-based approach to colorectal cancer: Survey of primary care physicians in Italy. Digestive and Liver Disease. 2003 Dec;35(12):869-875. https://doi.org/10.1016/j.dld.2003.07.005
Panzuto, F. ; Chiriatti, A. ; Bevilacqua, S. ; Giovannetti, P. ; Russo, G. ; Impinna, S. ; Pistilli, F. ; Capurso, G. ; Annibale, B. ; Delle Fave, Gianfranco ; Albanese, G. ; Augenti, N. ; Avolio, I. ; Azzolini, M. ; Bernardini, B. ; Bernardini, M. ; Bernoni, M. ; Bianco, D. ; Bocale, L. ; Borghesi, F. ; Borgna, G. ; Bottini, C. ; Bottini, M. ; Brandodoro, L. ; Busà, A. ; Cagliesi, F. ; Calicchia, A. ; Caponi, M. A. ; Cardarelli, B. ; Carli, M. ; Carlomagno, M. C. ; Casola, G. ; Cavaliere, G. ; Ceccarelli, E. ; Cerqua, R. ; Cesarini, M. ; Cianfoni, M. ; Ciucci, E. ; Conte, S. ; Cottani, A. ; Creo, U. ; Dani, S. ; De Angelis, P. ; De Bonis, G. ; De Liggio, F. ; De Simone, A. ; De Tommasi, R. ; Di Roberto, M. ; Di Viccaro, D. ; Donato, M. ; Faggiani, C. ; Feola, G. ; Ficuccilli, M. ; Forleo, F. ; Frugeri, T. ; Galassi, A. ; Gargaro, A. ; Gatti, V. ; Gaveglia, A. ; Granatelli, M. ; Grandi, M. ; Grattarola, S. ; Grimaldi, E. ; Grisanti, A. M. ; Iacovone, N. ; Izzo, V. ; Jarosinska, M. M. ; Kissopoulos, G. ; La Paglia, R. ; Lauretti, M. ; Litta, A. ; Lo Prete, P. ; Longhi, L. ; Lori, M. ; Macrì, R. ; Madonna, M. L. ; Mammucari, E. ; Mancini, M. ; Mango, R. ; Marasca, M. ; Marchionni, A. ; Margotti, G. ; Marinaro, C. ; Marziale, D. ; Mazzilli, M. ; Merletti, E. ; Messina, G. ; Michelangeli, L. ; Milioni, A. ; Mingarelli, C. ; Montuori, G. ; Mormile, A. ; Murano, L. ; Mutalipassi, G. ; Muzzu Martis, P. ; Natili, T. ; Nicolini, G. ; Nigro, A. ; Orazietti, M. / Symptom-based approach to colorectal cancer : Survey of primary care physicians in Italy. In: Digestive and Liver Disease. 2003 ; Vol. 35, No. 12. pp. 869-875.
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title = "Symptom-based approach to colorectal cancer: Survey of primary care physicians in Italy",
abstract = "Background. Colorectal cancer is a frequent cause of mortality in Western countries, including Italy, where a definite screening policy has not yet been adopted. It is likely that most patients with colorectal cancer refer, first of all, to their primary care physician at onset of symptoms. Aim. To perform a survey on the approach, of primary care physicians, to patients with symptoms suggesting the presence of colorectal cancer. Methods. A total of 280 consecutive symptomatic patients without previous diagnosis of organic colon disease or recent colon investigation in whom, after consulting, 159 primary care physicians in Lazio (Italy) prescribed colonoscopy or double-contrast barium enema. Results. Most frequent presenting symptoms were lower abdominal pain (79.6{\%}), bloating (59.6{\%}), constipation (47.8{\%}), diarrhoea (30.3{\%}), iron deficiency anaemia (24.6{\%}), change in bowel habits (20.3{\%}) and weight loss (15{\%}). Colonoscopy and barium enema were equally advised by physicians to rule out the presence of cancer (56{\%} versus 44{\%}, P = ns). Cancer was found in 14.6{\%} of patients. Age >50 years and iron deficiency anaemia were the only independent variables associated with colorectal cancer (Odds ratios 9.0 and 8.8 at multivariate analysis, respectively). Conclusion. The symptom-based selection criteria used by primary care physicians have been shown to be scarcely effective. Colonic investigation should be requested, irrespective to the symptoms, in patients aged >50 years with iron deficiency anaemia.",
keywords = "Colorectal cancer, Iron deficiency anaemia, Primary care physicians",
author = "F. Panzuto and A. Chiriatti and S. Bevilacqua and P. Giovannetti and G. Russo and S. Impinna and F. Pistilli and G. Capurso and B. Annibale and {Delle Fave}, Gianfranco and G. Albanese and N. Augenti and I. Avolio and M. Azzolini and B. Bernardini and M. Bernardini and M. Bernoni and D. Bianco and L. Bocale and F. Borghesi and G. Borgna and C. Bottini and M. Bottini and L. Brandodoro and A. Bus{\`a} and F. Cagliesi and A. Calicchia and Caponi, {M. A.} and B. Cardarelli and M. Carli and Carlomagno, {M. C.} and G. Casola and G. Cavaliere and E. Ceccarelli and R. Cerqua and M. Cesarini and M. Cianfoni and E. Ciucci and S. Conte and A. Cottani and U. Creo and S. Dani and {De Angelis}, P. and {De Bonis}, G. and {De Liggio}, F. and {De Simone}, A. and {De Tommasi}, R. and {Di Roberto}, M. and {Di Viccaro}, D. and M. Donato and C. Faggiani and G. Feola and M. Ficuccilli and F. Forleo and T. Frugeri and A. Galassi and A. Gargaro and V. Gatti and A. Gaveglia and M. Granatelli and M. Grandi and S. Grattarola and E. Grimaldi and Grisanti, {A. M.} and N. Iacovone and V. Izzo and Jarosinska, {M. M.} and G. Kissopoulos and {La Paglia}, R. and M. Lauretti and A. Litta and {Lo Prete}, P. and L. Longhi and M. Lori and R. Macr{\`i} and Madonna, {M. L.} and E. Mammucari and M. Mancini and R. Mango and M. Marasca and A. Marchionni and G. Margotti and C. Marinaro and D. Marziale and M. Mazzilli and E. Merletti and G. Messina and L. Michelangeli and A. Milioni and C. Mingarelli and G. Montuori and A. Mormile and L. Murano and G. Mutalipassi and {Muzzu Martis}, P. and T. Natili and G. Nicolini and A. Nigro and M. Orazietti",
year = "2003",
month = "12",
doi = "10.1016/j.dld.2003.07.005",
language = "English",
volume = "35",
pages = "869--875",
journal = "Digestive and Liver Disease",
issn = "1590-8658",
publisher = "Elsevier B.V.",
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TY - JOUR

T1 - Symptom-based approach to colorectal cancer

T2 - Survey of primary care physicians in Italy

AU - Panzuto, F.

AU - Chiriatti, A.

AU - Bevilacqua, S.

AU - Giovannetti, P.

AU - Russo, G.

AU - Impinna, S.

AU - Pistilli, F.

AU - Capurso, G.

AU - Annibale, B.

AU - Delle Fave, Gianfranco

AU - Albanese, G.

AU - Augenti, N.

AU - Avolio, I.

AU - Azzolini, M.

AU - Bernardini, B.

AU - Bernardini, M.

AU - Bernoni, M.

AU - Bianco, D.

AU - Bocale, L.

AU - Borghesi, F.

AU - Borgna, G.

AU - Bottini, C.

AU - Bottini, M.

AU - Brandodoro, L.

AU - Busà, A.

AU - Cagliesi, F.

AU - Calicchia, A.

AU - Caponi, M. A.

AU - Cardarelli, B.

AU - Carli, M.

AU - Carlomagno, M. C.

AU - Casola, G.

AU - Cavaliere, G.

AU - Ceccarelli, E.

AU - Cerqua, R.

AU - Cesarini, M.

AU - Cianfoni, M.

AU - Ciucci, E.

AU - Conte, S.

AU - Cottani, A.

AU - Creo, U.

AU - Dani, S.

AU - De Angelis, P.

AU - De Bonis, G.

AU - De Liggio, F.

AU - De Simone, A.

AU - De Tommasi, R.

AU - Di Roberto, M.

AU - Di Viccaro, D.

AU - Donato, M.

AU - Faggiani, C.

AU - Feola, G.

AU - Ficuccilli, M.

AU - Forleo, F.

AU - Frugeri, T.

AU - Galassi, A.

AU - Gargaro, A.

AU - Gatti, V.

AU - Gaveglia, A.

AU - Granatelli, M.

AU - Grandi, M.

AU - Grattarola, S.

AU - Grimaldi, E.

AU - Grisanti, A. M.

AU - Iacovone, N.

AU - Izzo, V.

AU - Jarosinska, M. M.

AU - Kissopoulos, G.

AU - La Paglia, R.

AU - Lauretti, M.

AU - Litta, A.

AU - Lo Prete, P.

AU - Longhi, L.

AU - Lori, M.

AU - Macrì, R.

AU - Madonna, M. L.

AU - Mammucari, E.

AU - Mancini, M.

AU - Mango, R.

AU - Marasca, M.

AU - Marchionni, A.

AU - Margotti, G.

AU - Marinaro, C.

AU - Marziale, D.

AU - Mazzilli, M.

AU - Merletti, E.

AU - Messina, G.

AU - Michelangeli, L.

AU - Milioni, A.

AU - Mingarelli, C.

AU - Montuori, G.

AU - Mormile, A.

AU - Murano, L.

AU - Mutalipassi, G.

AU - Muzzu Martis, P.

AU - Natili, T.

AU - Nicolini, G.

AU - Nigro, A.

AU - Orazietti, M.

PY - 2003/12

Y1 - 2003/12

N2 - Background. Colorectal cancer is a frequent cause of mortality in Western countries, including Italy, where a definite screening policy has not yet been adopted. It is likely that most patients with colorectal cancer refer, first of all, to their primary care physician at onset of symptoms. Aim. To perform a survey on the approach, of primary care physicians, to patients with symptoms suggesting the presence of colorectal cancer. Methods. A total of 280 consecutive symptomatic patients without previous diagnosis of organic colon disease or recent colon investigation in whom, after consulting, 159 primary care physicians in Lazio (Italy) prescribed colonoscopy or double-contrast barium enema. Results. Most frequent presenting symptoms were lower abdominal pain (79.6%), bloating (59.6%), constipation (47.8%), diarrhoea (30.3%), iron deficiency anaemia (24.6%), change in bowel habits (20.3%) and weight loss (15%). Colonoscopy and barium enema were equally advised by physicians to rule out the presence of cancer (56% versus 44%, P = ns). Cancer was found in 14.6% of patients. Age >50 years and iron deficiency anaemia were the only independent variables associated with colorectal cancer (Odds ratios 9.0 and 8.8 at multivariate analysis, respectively). Conclusion. The symptom-based selection criteria used by primary care physicians have been shown to be scarcely effective. Colonic investigation should be requested, irrespective to the symptoms, in patients aged >50 years with iron deficiency anaemia.

AB - Background. Colorectal cancer is a frequent cause of mortality in Western countries, including Italy, where a definite screening policy has not yet been adopted. It is likely that most patients with colorectal cancer refer, first of all, to their primary care physician at onset of symptoms. Aim. To perform a survey on the approach, of primary care physicians, to patients with symptoms suggesting the presence of colorectal cancer. Methods. A total of 280 consecutive symptomatic patients without previous diagnosis of organic colon disease or recent colon investigation in whom, after consulting, 159 primary care physicians in Lazio (Italy) prescribed colonoscopy or double-contrast barium enema. Results. Most frequent presenting symptoms were lower abdominal pain (79.6%), bloating (59.6%), constipation (47.8%), diarrhoea (30.3%), iron deficiency anaemia (24.6%), change in bowel habits (20.3%) and weight loss (15%). Colonoscopy and barium enema were equally advised by physicians to rule out the presence of cancer (56% versus 44%, P = ns). Cancer was found in 14.6% of patients. Age >50 years and iron deficiency anaemia were the only independent variables associated with colorectal cancer (Odds ratios 9.0 and 8.8 at multivariate analysis, respectively). Conclusion. The symptom-based selection criteria used by primary care physicians have been shown to be scarcely effective. Colonic investigation should be requested, irrespective to the symptoms, in patients aged >50 years with iron deficiency anaemia.

KW - Colorectal cancer

KW - Iron deficiency anaemia

KW - Primary care physicians

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U2 - 10.1016/j.dld.2003.07.005

DO - 10.1016/j.dld.2003.07.005

M3 - Article

VL - 35

SP - 869

EP - 875

JO - Digestive and Liver Disease

JF - Digestive and Liver Disease

SN - 1590-8658

IS - 12

ER -