Diagnostic indicator | Round 1 (mean score for importance) | Round 2 (mean rank score) | Round 3 (crucial) |
---|---|---|---|
Key risk factor | |||
Familial polyposis colia | 4.92 | 2.44 | Y |
First-degree relative with colorectal cancer <50 yearsa | 4.85 | 3.61 | Y |
Agea | 4.54 | 3.17 | Y |
More than 10 polypsa | 4.38 | 6.67 | Y |
First-degree relative with polyps <50 yearsa | 4.27 | 5.94 | Y |
Second attendance with the same symptoma | 4.23 | 9.28 | Y |
Inflammatory bowel diseasea | 4.15 | 6.72 | Y |
Benign polyps | 3.73 | 10.28 | Nb |
Smoking status | 3.35 | 10.83 | Nb |
First-degree relative with other type of cancer | 3.42 | 11.89b | |
History of endometrial cancer | 3.23 | 12.56b | |
Last consultation with a GP >6 months ago | 3.15 | 13.56b | |
Alcohol intake | 3.00 | 13.78b | |
Socioeconomic statusb | 2.92b | ||
Ethnicityb | 2.88b | ||
Diabetes mellitusb | 2.73b | ||
Sexb | 2.65b | ||
Occupational historyb | 2.46b | ||
Progression of symptomsa,c | 5.33 | Y | |
Patient thinks they have colorectal cancera,c | 10.94 | Y | |
Last consultation with a GP >5 years agoc | 11.00 | ||
Patient attends with an adult family memberc | 15.00 | ||
Symptom | |||
Rectal bleeding: blood mixed with stoola | 4.73 | 1.88 | Y |
Bowel symptoms: change in bowel habita | 4.73 | 3.24 | Y |
Unintentional loss of weight reported by patienta | 4.73 | 4.82 | Y |
Rectal bleeding: typea,d | 4.50 | 4.06 | Y |
Symptom durationa,e | 4.46 | 8.35 | Y |
Bowel symptoms: tenesmusa | 4.08 | 8.76 | Y |
Bowel symptoms: urgency | 3.88 | 9.71 | Nb |
Bowel symptoms: incomplete emptyinga | 3.88 | 9.29 | Y |
Bowel symptoms: diarrhoeaa | 3.81 | 8.24 | Y |
Fatigue | 3.77 | 15.35b | |
Loss of appetite | 3.73 | 13.35b | |
Abdominal pain | 3.69 | 11.24b | |
Bowel symptoms: nocturnal symptoms | 3.62 | 11.47b | |
Bowel symptoms: constipation | 3.42 | 14.94b | |
Distension | 3.42 | 14.88b | |
Discomfort | 3.27 | 16.65b | |
Peri-anal symptoms | 3.23 | 14.47b | |
Bloating | 3.12 | 16.53b | |
Nauseab | 2.88b | ||
Jaundicea,c | 8.24 | Y | |
Mucus in stoolc | 17.12b | ||
Wet windc | 18.41b | ||
Sign | |||
Rectal massa | 4.96 | 1.88 | Y |
Abdominal massa | 4.85 | 3.12 | Y |
Cachexiaa | 4.81 | 4.53 | Y |
Objective loss of weighta | 4.65 | 4.59 | Y |
Rectal examination: blood on glovea | 4.27 | 5.29 | Y |
Ascites | 4.54 | 6.00b | |
Hepatomegaly | 4.31 | 6.12b | |
Pale conjunctivae | 3.73 | 8.29b | |
Lymphadenopathy | 3.73 | 7.76b | |
Melaenac | 7.41b | ||
Test | |||
Iron deficiency anaemiaa | 4.77 | 1.12 | Y |
Anaemia | 4.15 | 2.94 | Nb |
Positive faecal occult blood testa | 3.96 | 3.53 | Y |
Raised erythrocyte sedimentation rate | 3.73 | 4.18b | |
Screened for colorectal cancer in the last 2 years | 3.54 | 4.76b | |
High white cell countb | 2.54b | ||
Raised glucose levelb | 2.35b | ||
Disturbed liver function testsc | 5.06b | ||
Hypercalcaemiac | 6.41b |
↵a Included in round 3.
↵b Excluded in round 2.
↵c Added by participants in round 1.
↵d Refers to characteristics of the rectal bleeding experienced (for example, dark versus bright red blood, whether the blood was noticed in the toilet pan or on the toilet paper.
↵e Refers to whether the symptom was present for a long period of time as opposed to only a short period.