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Colon Ca alert in men

By Daniel Cressey

Key symptoms for colorectal cancer indicate the disease far more strongly in men than in women, a new UK study reveals.

The researchers called for a change in national guidelines to encourage referral more often in men while suggesting watchful waiting in some women.

NICE guidance does not differentiate between the sexes but the new study found the predictive value of some symptoms was nearly three times as high in men as in women.

The University of Surrey study also backed research reported by Pulse in identifying rectal bleeding as a key sign of cancer, but found on its own it might only warrant referral in men.

Study leader Professor Ross Lawrenson, now professor of primary care at the Auckland Medical School in New Zealand, said: 'The interesting finding is that men with symptoms like rectal bleeding are at much higher risk than women. This is surprising as you'd think even if the incidence differs, once you develop symptoms the risk would then be the same.

'I think GPs have this gut feeling men present later and are more likely to have underlying disease, but there are few studies showing this to be true.'

Professor Lawrenson's study analysed data on nearly 2.8 million patients aged over 40 on the UK general practice research database. In patients aged 60 to 69 with anaemia, 3.0 per cent of men but only 1.4 per cent of women developed colorectal cancer in the following year.

In the same age group changes in bowel habit had a positive predictive value of

6.9 per cent in men but 2.4 per cent in women, and rectal bleeding 6.0 and 3.5 per cent


A combination of any two of these symptoms doubled the cancer risk, the researchers reported in the latest issue of the European Journal of Cancer Care.

Professor Lawrenson said guidelines should be re-assessed to give men a higher priority for referral.

Dr Murray Freeman, a GP in Birkenhead and cancer lead for Wirral PCTs, said: 'If it's such a large study and the results are so definite then there clearly is a sex differentiation and maybe that's something we should be looking at.'

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