title: Prioritization of patients with rectal bleeding for urgent outpatient colonoscopy--a pilot study.
abstract: OBJECTIVE
  Rectal bleeding is a common symptom in general practice and may be associated with colorectal neoplasia. Waiting-lists for outpatient colonoscopies and first specialist appointments are long. The aim of our study was to determine the value of presenting signs and symptoms in prioritising patients with rectal bleeding for urgent colonoscopy.
  
  
  METHODS
  Patients were asked to fill out a 'Bowel symptoms Assessment Questionnaire' at their first visit to a Colorectal Clinic. Patients were then assessed by clinicians who referred them for further investigations as appropriate. Factors from the questionnaire (e.g. age, family history, perianal symptoms, and so on) were analysed to assess correlation with colorectal cancer or neoplasia. These were analysed using logistic regression, SPSS Answertree and 2x2 tables.
  
  
  RESULTS
  105 patients completed the questionnaire. Thirty patients had colonoscopy/barium enema. Fifteen patients had colorectal cancer (CRC) or neoplasia detected. There was a significant increase in risk of developing CRC or neoplasia in patients above the age of 67 or if they had a positive family history of CRC or neoplasia.
  
  
  CONCLUSIONS
  We conclude that patients with rectal bleeding, above the age of 67 or those with a positive family history are at a higher risk of neoplasia and should receive priority access to colonoscopy prior to first specialist assessment.
authors.affiliation: Department of Surgery, University of Auckland, Middlemore Hospital, Otahuhu, Auckland.
authors.forename: Akanksha
authors.initials: A
authors.lastname: Bhargava
authors.forename: Ali
authors.initials: A
authors.lastname: Aldameh
authors.forename: Joanna
authors.initials: J
authors.lastname: Stewart
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Hill
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D003113:Colonoscopy; D004638:Emergency Treatment; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000628:therapy; D006292:Health Priorities; D006801:Humans; D008875:Middle Aged; D009520:New Zealand; D010865:Pilot Projects; D012007:Rectum; D014850:Waiting Lists