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Eur J Gen Pract. 2016 Jun;22(2):91-5. doi: 10.3109/13814788.2016.1148135. Epub 2016 Mar 22.

The value of reasons for encounter in early detection of colorectal cancer.

Author information

a Department of Primary and Community Care , Radboud University Nijmegen Medical Centre , Nijmegen , The Netherlands ;
b Formerly of the Department of General Practice , Academic Medical Centre, University of Amsterdam , Amsterdam , the Netherlands ;
c Department of Primary and Community Care , Radboud University Medical Centre, Nijmegen, The Netherlands ;
d Australian Primary Health Care Research Institute , Australian National University , Canberra , Australia.



Symptoms with a high predictive power for colorectal cancer (CRC) do not exist.


To explore the predictive value of patients' reason for encounter (RFE) in the two years prior to the diagnosis of CRC.


A retrospective nested case-control study using prospectively collected data from electronic records in general practice over 20 years. Matching was done based on age (within two years), gender and practice. The positive likelihood ratios (LR+) and odds ratios (OR) were calculated for RFE between cases and controls in the two years before the index date.


We identified 184 CRC cases and matched 366 controls. Six RFEs had significant LR + and ORs for CRC, which may have high predictive power. These RFEs are part of four chapters in the International Classification of Primary Care (ICPC) that include tiredness (significant at 3-6 months prior to the diagnosis; LR+ 2.6 and OR 3.07; and from 0 to 3 months prior to the diagnosis; LR+ 2.0 and OR 2.36), anaemia (significant at three months before diagnosis; LR+ 9.8 and OR 16.54), abdominal pain, rectal bleeding and constipation (significant at 3-6 months before diagnosis; LR+ 3.0 and OR 3.33; 3 months prior to the diagnosis LR+ 8.0 and OR 18.10) and weight loss (significant at three months before diagnosis; LR+ 14.9 and OR 14.53).


Data capture and organization in ICPC permits study of the predictive value of RFE for CRC in primary care.


Reason for encounter; colorectal cancer; diagnosis; primary care

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