Prostate cancer consultations are common in primary care and there is no one approach to testing and treatment that fits all patients. Urologist Simon van Rij discusses the key considerations and options for personalised care, appropriate investigation and treatment
Back-to-front advice on bowel cancer detection
Back-to-front advice on bowel cancer detection
FIT testing for symptomatic patients is beneficial for determining patients at high risk of colon cancer, so why are GPs not allowed to request it, asks emeritus GPJim Vause
[i]Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death. Bretthauer M, Løberg M, Wieszczy P et al for the NordICC Study Group. NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2208375
[ii] Hunched over in pain, vomiting, mum-of-two still denied the tests needed to diagnose her bowel cancer
Jo Mckenzie-Mclean Stuff. https://tinyurl.com/mutmxpz4
[iii] Pin-Vieito N, Puga M, Fernández-de-Castro D, Cubiella J. Faecal immunochemical test outside colorectal cancer screening? World J Gastroenterol. 2021 Oct 14;27(38):6415-6429. doi: 10.3748/wjg.v27.i38.6415. PMID: 34720531; PMCID: PMC8517780.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8517780/
[iv] Del Giudice ME, Vella ET, Hey A, Simunovic M, Harris W, Levitt C. Systematic review of clinical features of suspected colorectal cancer in primary care. Can Fam Physician. 2014 Aug;60(8):e405-15. PMID: 25122831; PMCID: PMC4131977.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4131977/
[v] Chen CH, Wen CP, Tsai MK. Fecal immunochemical test for colorectal cancer from a prospective cohort with 513,283 individuals: Providing detailed number needed to scope (NNS) before colonoscopy. Medicine (Baltimore). 2016 Sep;95(36):e4414. doi: 10.1097/MD.0000000000004414. PMID: 27603337; PMCID: PMC5023859.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5023859/#:~:text=FIT%20value%20above%20100%20ng,2).
[vi] Ministry of Health. 2019. Referral Criteria for Direct Access Outpatient Colonoscopy or Computed Tomography Colonography https://www.health.govt.nz/system/files/documents/publications/referral-criteria-direct-access-outpatient-colonoscopy-computed-tomography-colonography-feb19-v2.pdf
[vii] Monahan KJ, Davies MM, Abulafi M, et alFaecal immunochemical testing (FIT) in patients with signs or symptoms of suspected colorectal cancer (CRC): a joint guideline from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG)Gut 2022;71:1939-1962. https://gut.bmj.com/content/71/10/1939