{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:38:34Z","timestamp":1790789914988,"version":"4.1.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2008,7,11]],"date-time":"2008-07-11T00:00:00Z","timestamp":1215734400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Lynn's Bowel Cancer Campaign","award":["1099455"],"award-info":[{"award-number":["1099455"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,8,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The aim was to identify the patients with colorectal symptoms most likely to benefit from whole colonic imaging (WCI) to diagnose colorectal cancer and those for whom flexible sigmoidoscopy (FS) may be initially sufficient.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This prospective observational study (16 years) included 16 433 newly referred patients with symptoms or signs of colorectal cancer.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Colorectal cancer was diagnosed in 946 patients (diagnostic yield 5\u00b78 per cent), 815 (86\u00b72 per cent) in the rectum or sigmoid (distal) and 131 (13\u00b78 per cent) in the proximal colon. Some 15 829 patients (96\u00b73 per cent) presented with symptoms alone (without iron deficiency anaemia or abdominal mass). Of 787 cancers in these patients, 750 (95\u00b73 per cent) were distal. The prevalence of proximal cancer above and below the age of 60 years was 0\u00b74 per cent (33 of 8249) and 0\u00b71 per cent (four of 7580) respectively. Of 16 256 patients having FS, 5665 (34\u00b78 per cent) had WCI. Of the other 10 591, five subsequently presented with proximal cancers. FS missed ten (1\u00b73 per cent) of 796 cancers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Patients with iron deficiency anaemia or a mass require WCI. However, in patients with symptoms alone, FS detects 95 per cent of cancers, and the diagnostic yield of WCI after FS is very low. Alternative management strategies need to be developed to avoid unnecessary investigations in this low-risk group.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.6234","type":"journal-article","created":{"date-parts":[[2008,7,11]],"date-time":"2008-07-11T14:52:26Z","timestamp":1215787946000},"page":"1140-1146","source":"Crossref","is-referenced-by-count":26,"title":["Flexible sigmoidoscopy and whole colonic imaging in the diagnosis of cancer in patients with colorectal symptoms"],"prefix":"10.1093","volume":"95","author":[{"given":"M R","family":"Thompson","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Queen Alexandra Hospital, Portsmouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K G","family":"Flashman","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Queen Alexandra Hospital, Portsmouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Wooldrage","sequence":"additional","affiliation":[{"name":"Cancer Research UK, Colorectal Cancer Unit, St Mark's Hospital, Harrow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P A","family":"Rogers","sequence":"additional","affiliation":[{"name":"Cancer Research UK, Colorectal Cancer Unit, St Mark's Hospital, Harrow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Senapati","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Queen Alexandra Hospital, Portsmouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D P","family":"O'Leary","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Queen Alexandra Hospital, Portsmouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Atkin","sequence":"additional","affiliation":[{"name":"Cancer Research UK, Colorectal Cancer Unit, St Mark's Hospital, Harrow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2008,7,11]]},"reference":[{"key":"2021070911131632400_bib1","first-page":"367","article-title":"Utilization of sigmoidoscopy by family physicians in Canada","volume":"150","author":"Glaser","year":"1994","journal-title":"CMAJ"},{"key":"2021070911131632400_bib2","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1046\/j.1463-1318.2002.00326.x","article-title":"Flexible sigmoidoscopy in general practice","volume":"4","author":"Vellacott","year":"2002","journal-title":"Colorectal Dis"},{"key":"2021070911131632400_bib3","volume-title":"The Nurse Endoscopist. 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