Risk Assessment Tool Helps UK GPs Diagnose Serious Bowel Conditions in Younger Patients

Risk Assessment Tool Helps UK GPs Diagnose Serious Bowel Conditions in Younger Patients

A new research-based risk assessment tool will help general practitioners identify symptoms of bowel cancer and inflammatory bowel disease (IBD) in patients under 50 years of age.

The assessment tool was developed by researchers at the University of Exeter, in collaboration with Durham University, University Hospital of North Tees and the “Bowel Cancer UK: Never Too Young” campaign.

This is the first test of its kind for younger people and was developed to speed up diagnoses in patients who typically experience significant delays.

According to the “Never Too Young” campaign, every year 2,500 younger people are diagnosed with bowel cancer in the U.K. While this is only around 5% of those diagnosed, the number is slowly increasing. Additionally, across all ages, 13,000 people are diagnosed with IBDs in the U.K. every year, many of whom are under 50.

Diagnosis is difficult, as symptoms for bowel cancer and IBDs are common and caused not only by these diseases. As a consequence, younger people usually face delays in their diagnoses, reducing their chances of survival.

According to the findings outlined in an article published in the British Journal of General Practice, titled “Clinical features of bowel disease in patients aged <50 years in primary care: a large case-control study,” the tool helps general practitioners (GPs) determine who needs further testing by predicting the level of risk, depending on the patients’ symptoms.

With the assistance of a physical examination and a blood test, the tool classifies patients according to risk percentage:

  • If the score is higher than 3% patients should get a referral for an urgent colonoscopy to examine the inside of the bowel, or be sent to see a specialist.
  • If the score is between 1% and 3%, patients should get a referral for a faecal calprotectin test,to see if there is any inflammation in the bowel. This test also can help rule out non-serious conditions.
  • A score less than 1% does not require any further testing and GPs should just monitor their patients.

“The risk assessment tool should be used as a reminder to GPs to consider the likelihood of an individual patient having a serious bowel condition given the symptom or combination of symptoms they present with. The tool does not replace clinical judgement but provides more information to base a referral decision,” Willie Hamilton, MD, leader of the study, said in an Exeter news story.

Emma Mathews, from Newquay in Cornwall, saw her husband Martyn die at age 34 after waiting a full year for a cancer diagnosis.

“I really welcome this new diagnosis tool to help clinicians identify bowel cancer in younger people. Martyn’s death broke my heart. He was so positive throughout and fought so hard to survive. It was soul destroying to see him suffer and to lose him,” said Emma.

Witnessing what happened to her husband, Emma decided to share Martyn’s memory in a dedicated website, which includes pictures, his biography, facts about Martyn and a link to the “Never too Young” campaign, which is giving younger patients a voice and changing clinical practice and policy to stop bowel cancer in people under 50.

“We launched our flagship Never Too Young campaign in 2013 to highlight the experiences of young people for the first time and to improve their diagnosis, treatment and care so that more lives are saved. Delayed diagnosis is all too common for young patients with both bowel cancer and inflammatory bowel disease therefore finding quicker, more effective ways to identify and diagnose these patients earlier is crucial. Our research shows that one in five young patients have to visit their GP five times or more before they get their diagnosis and this is simply not acceptable,” said Deborah Alsina, chief executive of Bowel Cancer UK.

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