Diagnosis of XXXX in primary care: the evidence base for guidelines.

@entity1 @entity417 @entity548 @entity5 @entity490 @entity14 @entity1142 @entity68
BACKGROUND: @entity14 is common, causing approximately 11% of @entity5 deaths in the UK. However, a GP would only expect to see one new presentation each year. Referral guidelines outlining clinical scenarios of high risk have been published. These aim to help GPs select @entity1 for rapid investigation. OBJECTIVES: The purpose of this study was to review the presenting features of @entity14 in primary care, using the basic structure of the UK Referral Guidelines for Suspected @entity5 . METHODS: A structured literature review was carried out. RESULTS: Two symptoms have a high predictive value for @entity5 : @entity548 and change in bowel habit towards increased looseness or increased stool frequency. Other symptoms, such as @entity490 , are so prevalent in the community that they have little predictive value. There is little published evidence on abdominal or rectal masses and @entity68 deficiency @entity417 as presenting features for @entity14 . However, these are so likely to have an important cause, investigation is mandated. Two areas in the Referral Guidelines are questioned: the need to defer investigation of change in bowel habit towards increased looseness or increased stool frequency for 6 weeks, and the low risk nature of @entity1142 . CONCLUSION: The Referral Guidelines have a reasonable evidence base.
