{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T23:34:15Z","timestamp":1771025655344,"version":"3.50.1"},"reference-count":48,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2014,4,1]],"date-time":"2014-04-01T00:00:00Z","timestamp":1396310400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2014,4,1]],"date-time":"2014-04-01T00:00:00Z","timestamp":1396310400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["cghjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Clinical Gastroenterology and Hepatology"],"published-print":{"date-parts":[[2014,4]]},"DOI":"10.1016\/j.cgh.2013.07.008","type":"journal-article","created":{"date-parts":[[2013,7,23]],"date-time":"2013-07-23T16:55:25Z","timestamp":1374598525000},"page":"669-675","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":18,"title":["Disparities in Evaluation of Patients With Rectal Bleeding 40 Years and Older"],"prefix":"10.1016","volume":"12","author":[{"given":"Helen M.","family":"Shields","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena M.","family":"Stoffel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel C.","family":"Chung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas D.","family":"Sequist","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin W.","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen R.","family":"Pelletier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Spencer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean M.","family":"Silk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bonita L.","family":"Austin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Diguette","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean E.","family":"Furbish","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Lederman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saul N.","family":"Weingart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.cgh.2013.07.008_bib1","first-page":"41","article-title":"Cancer Screening\u2014United States 2010","volume":"61","author":"Klabunde","year":"2012","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"10.1016\/j.cgh.2013.07.008_bib2","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1158\/1055-9965.EPI-11-0220","article-title":"Trends in colorectal cancer test use among vulnerable populations in the United States","volume":"20","author":"Klabunde","year":"2011","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"10.1016\/j.cgh.2013.07.008_bib3","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1001\/jama.1997.03540250052031","article-title":"History of visible rectal bleeding in a primary care population","volume":"277","author":"Helfand","year":"1997","journal-title":"JAMA"},{"key":"10.1016\/j.cgh.2013.07.008_bib4","first-page":"267","article-title":"Risk of colorectal cancer in general practice patients presenting with rectal bleeding, change in bowel habit or anaemia","volume":"15","author":"Lawrenson","year":"2006","journal-title":"Eur J Cancer Care"},{"key":"10.1016\/j.cgh.2013.07.008_bib5","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1136\/bmj.39171.637106.AE","article-title":"Alarm symptoms in early diagnosis of cancer in primary care: cohort study using General Practice Research Database","volume":"334","author":"Jones","year":"2007","journal-title":"BMJ"},{"key":"10.1016\/j.cgh.2013.07.008_bib6","first-page":"949","article-title":"Factors identifying higher risk rectal bleeding in general practice","volume":"55","author":"Ellis","year":"2005","journal-title":"Br J Gen Pract"},{"key":"10.1016\/j.cgh.2013.07.008_bib7","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1097\/MD.0b013e3181881354","article-title":"Young-onset colorectal cancer in patients with no known genetic predisposition. Can we increase early recognition and improve outcome?","volume":"87","author":"Dozois","year":"2008","journal-title":"Medicine"},{"key":"10.1016\/j.cgh.2013.07.008_bib8","series-title":"Risk management foundation: colorectal cancer screening algorithm","author":"Shields","year":"2006"},{"key":"10.1016\/j.cgh.2013.07.008_bib9","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1053\/gast.2003.50044","article-title":"Colorectal cancer screening and\u00a0surveillance: clinical guidelines and rationale-update based on evidence","volume":"124","author":"Winawer","year":"2003","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2013.07.008_bib10","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/j.gie.2005.07.032","article-title":"ASGE guideline: the role of endoscopy in the patient with lower-GI bleeding","volume":"62","author":"Davila","year":"2005","journal-title":"Gastrointest Endosc"},{"key":"10.1016\/j.cgh.2013.07.008_bib11","doi-asserted-by":"crossref","first-page":"2660","DOI":"10.1023\/A:1012715110440","article-title":"Endoscopy for hematochezia in patients under 50 years of age","volume":"46","author":"Lewis","year":"2001","journal-title":"Dig Dis Sci"},{"key":"10.1016\/j.cgh.2013.07.008_bib12","first-page":"171","article-title":"The value of flexible sigmoidoscopy for patients with bright red rectal bleeding","volume":"9","author":"Choi","year":"2003","journal-title":"Hong Kong Med J"},{"key":"10.1016\/j.cgh.2013.07.008_bib13","doi-asserted-by":"crossref","first-page":"458","DOI":"10.4321\/S1130-01082011000900004","article-title":"Colorectal cancer and its delayed diagnosis: have we improved in the past 25 years?","volume":"103","author":"Cerdan-Santacruz","year":"2011","journal-title":"Rev Esp Enferm Dig"},{"key":"10.1016\/j.cgh.2013.07.008_bib14","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/S0140-6736(86)92081-7","article-title":"How important is rectal bleeding in\u00a0the diagnosis of bowel cancer and polyps?","volume":"2","author":"Goulston","year":"1986","journal-title":"Lancet"},{"key":"10.1016\/j.cgh.2013.07.008_bib15","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1055\/s-0030-1256356","article-title":"Is full colonoscopic examination necessary in young patients with fresh bleeding per rectum?","volume":"43","author":"Khalid","year":"2011","journal-title":"Endoscopy"},{"key":"10.1016\/j.cgh.2013.07.008_bib16","doi-asserted-by":"crossref","first-page":"2011","DOI":"10.1111\/j.1572-0241.2007.01332.x","article-title":"Lack of colonic neoplastic lesions in patients under 50 yr of age with hematochezia: a multicenter prospective study","volume":"102","author":"Spinzi","year":"2007","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2013.07.008_bib17","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1053\/j.gastro.2004.02.030","article-title":"Rectal bleeding and diminutive colon polyps","volume":"126","author":"Lieberman","year":"2004","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2013.07.008_bib18","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/j.1572-0241.2001.03475.x","article-title":"Factors that influence the decision to do an adequate evaluation of a patient with a positive stool for occult blood","volume":"96","author":"Shields","year":"2001","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2013.07.008_bib19","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/S0016-5085(97)70214-2","article-title":"Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies","volume":"112","author":"Rex","year":"1997","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2013.07.008_bib20","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1056\/NEJMoa0907667","article-title":"Quality indicator for colonoscopy and the risk of interval cancer","volume":"362","author":"Kaminski","year":"2010","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.cgh.2013.07.008_bib21","doi-asserted-by":"crossref","first-page":"3044","DOI":"10.1002\/cncr.26602","article-title":"Prevalence and predictors of interval colorectal cancers in Medicare beneficiaries","volume":"118","author":"Cooper","year":"2012","journal-title":"Cancer"},{"key":"10.1016\/j.cgh.2013.07.008_bib22","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1016\/S0140-6736(05)60603-4","article-title":"Mortality differences between black and white men in the USA: contribution of income and other risk factors among men screened for the MRFIT","volume":"351","author":"Smith","year":"1998","journal-title":"Lancet"},{"key":"10.1016\/j.cgh.2013.07.008_bib23","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1136\/bmj.318.7187.843","article-title":"Postcodes as useful markers of social class: population based study in 26000 British households","volume":"318","author":"Danesh","year":"1999","journal-title":"BMJ"},{"key":"10.1016\/j.cgh.2013.07.008_bib24","doi-asserted-by":"crossref","first-page":"1950","DOI":"10.1158\/1055-9965.EPI-07-2774","article-title":"Effects of socioeconomic status and\u00a0treatment disparities in colorectal cancer survival","volume":"17","author":"Le","year":"2008","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"10.1016\/j.cgh.2013.07.008_bib25","doi-asserted-by":"crossref","first-page":"301","DOI":"10.3233\/CBM-2007-3604","article-title":"African-American and Caucasian disparities in colorectal cancer mortality and survival by data source: an epidemiologic review","volume":"3","author":"Alexander","year":"2007","journal-title":"Cancer Biomarkers Prev"},{"key":"10.1016\/j.cgh.2013.07.008_bib26","first-page":"85","article-title":"Increasing disparity in\u00a0colorectal cancer incidence and mortality among African-Americans and whites: a state's experience","volume":"2","author":"LoConte","year":"2011","journal-title":"J\u00a0Gastrointest Oncol"},{"key":"10.1016\/j.cgh.2013.07.008_bib27","doi-asserted-by":"crossref","first-page":"3734","DOI":"10.3748\/wjg.15.3734","article-title":"Disparities in colorectal cancer in African- Americans vs whites: before and after diagnosis","volume":"15","author":"Dimou","year":"2009","journal-title":"World J\u00a0Gastroenterol"},{"key":"10.1016\/j.cgh.2013.07.008_bib28","first-page":"14","article-title":"Diagnostic work-up of\u00a0rectal bleeding in general practice","volume":"55","author":"Heintze","year":"2005","journal-title":"Br J Gen Pract"},{"key":"10.1016\/j.cgh.2013.07.008_bib29","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1056\/NEJM199312303292701","article-title":"Prevention of colorectal cancer by colonoscopic polypectomy","volume":"329","author":"Winawer","year":"1993","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.cgh.2013.07.008_bib30","first-page":"227","article-title":"Cancer incidence and mortality patterns among specific Asian and Pacific Islander populations in the U.S","volume":"19","author":"Miller","year":"2008","journal-title":"Cancer Causes Control"},{"key":"10.1016\/j.cgh.2013.07.008_bib31","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/j.ypmed.2004.09.031","article-title":"Cancer screening among Latino subgroups in the United States","volume":"40","author":"Gorin","year":"2005","journal-title":"Prev Med"},{"key":"10.1016\/j.cgh.2013.07.008_bib32","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1007\/s11606-011-1783-9","article-title":"Cultural, economic, and psychological predictors of colonoscopy in a national sample","volume":"26","author":"Halbert","year":"2011","journal-title":"J\u00a0Gen Intern Med"},{"key":"10.1016\/j.cgh.2013.07.008_bib33","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.cgh.2007.12.009","article-title":"A\u00a0program to enhance completion of screening colonoscopy among urban minorities","volume":"6","author":"Chen","year":"2008","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10.1016\/j.cgh.2013.07.008_bib34","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1056\/NEJM199412223312501","article-title":"A\u00a0prospective study of family history and the risk of colorectal cancer","volume":"331","author":"Fuchs","year":"1994","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.cgh.2013.07.008_bib35","doi-asserted-by":"crossref","first-page":"125","DOI":"10.4251\/wjgo.v4.i6.125","article-title":"Colorectal cancer screening in patients at moderately increased risk due to family history","volume":"15","author":"Lin","year":"2012","journal-title":"World J Gastrointest Oncol"},{"key":"10.1016\/j.cgh.2013.07.008_bib36","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1111\/j.1572-0241.2004.40943.x","article-title":"Malpractice risks associated with colon cancer and inflammatory bowel disease","volume":"99","author":"Feld","year":"2004","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2013.07.008_bib37","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/BF02554525","article-title":"Rectal bleeding. Do other symptoms aid in diagnosis?","volume":"32","author":"Mant","year":"1989","journal-title":"Dis Colon Rectum"},{"key":"10.1016\/j.cgh.2013.07.008_bib38","first-page":"161","article-title":"Incidence and causes of rectal bleeding in general practice as detected by colonoscopy","volume":"46","author":"Metcalf","year":"1966","journal-title":"Br J Gen Pract"},{"key":"10.1016\/j.cgh.2013.07.008_bib39","first-page":"505","article-title":"Colorectal cancer surveillance in African-American and white patients at an urban university medical center","volume":"91","author":"Borum","year":"1999","journal-title":"J\u00a0Natl Med Assoc"},{"key":"10.1016\/j.cgh.2013.07.008_bib40","doi-asserted-by":"crossref","first-page":"2359","DOI":"10.1001\/jama.291.19.2359","article-title":"Communicating evidence for participatory decision making","volume":"291","author":"Epstein","year":"2004","journal-title":"JAMA"},{"key":"10.1016\/j.cgh.2013.07.008_bib41","doi-asserted-by":"crossref","first-page":"2313","DOI":"10.1001\/jama.282.24.2313","article-title":"Informed decision making in outpatient practice. Time to get back to the basics","volume":"282","author":"Braddock","year":"1999","journal-title":"JAMA"},{"key":"10.1016\/j.cgh.2013.07.008_bib42","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1136\/gutjnl-2011-300651","article-title":"Colonoscopy quality measures: experience from the NHS Bowel Cancer Screening Programme","volume":"61","author":"Lee","year":"2012","journal-title":"Gut"},{"key":"10.1016\/j.cgh.2013.07.008_bib43","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1111\/j.1572-0241.2006.01054.x","article-title":"Endoscopist can be more powerful than age and male gender in predicting adenoma detection at colonoscopy","volume":"102","author":"Chen","year":"2007","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2013.07.008_bib44","first-page":"CD001431","article-title":"Decision aids for people facing health treatment or screening decisions","volume":"10","author":"Stacey","year":"2011","journal-title":"Cochrane Library"},{"key":"10.1016\/j.cgh.2013.07.008_bib45","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1016\/j.jamcollsurg.2011.01.052","article-title":"Effective surgical safety checklist implementation","volume":"212","author":"Conley","year":"2011","journal-title":"J\u00a0Am Coll Surg"},{"key":"10.1016\/j.cgh.2013.07.008_bib46","doi-asserted-by":"crossref","first-page":"2635","DOI":"10.1056\/NEJMsa022615","article-title":"The quality of health care delivered to adults in the United States","volume":"348","author":"McGlynn","year":"2003","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.cgh.2013.07.008_bib47","doi-asserted-by":"crossref","first-page":"2579","DOI":"10.1001\/jama.283.19.2579","article-title":"Inequality in quality. Addressing socioeconomic, racial, and ethnic disparities in health care","volume":"283","author":"Fiscella","year":"2000","journal-title":"JAMA"},{"key":"10.1016\/j.cgh.2013.07.008_bib48","first-page":"36","article-title":"Barriers to colorectal cancer screening: inadequate knowledge by physicians","volume":"72","author":"Gennarelli","year":"2005","journal-title":"Mt Sinai J Med"}],"container-title":["Clinical Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1542356513010483?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1542356513010483?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T05:14:03Z","timestamp":1761542043000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1542356513010483"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4]]},"references-count":48,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2014,4]]}},"alternative-id":["S1542356513010483"],"URL":"https:\/\/doi.org\/10.1016\/j.cgh.2013.07.008","relation":{},"ISSN":["1542-3565"],"issn-type":[{"value":"1542-3565","type":"print"}],"subject":[],"published":{"date-parts":[[2014,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Disparities in Evaluation of Patients With Rectal Bleeding 40 Years and Older","name":"articletitle","label":"Article Title"},{"value":"Clinical Gastroenterology and Hepatology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.cgh.2013.07.008","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2014 AGA Institute. Published by Elsevier Ltd. All rights reserved.","name":"copyright","label":"Copyright"}]}}