{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:23:18Z","timestamp":1790900598256,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T00:00:00Z","timestamp":1713398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The value of lower gastrointestinal endoscopy (LGIE; colonoscopy or sigmoidoscopy) relates to its ability to detect clinically relevant findings, predominantly cancers, preneoplastic polyps or inflammatory bowel disease. There are concerns that many LGIEs are performed on low\u2010risk patients with limited benefit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To determine the diagnostic outcomes of LGIE for common symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a cross\u2010sectional study of diagnostic LGIE between March 2019 and February 2020 using the UK National Endoscopy Database. We used mixed\u2010effects logistic regression models, incorporating random (endoscopist) and fixed (symptoms, patient age, and sex) effects upon two dependent variables (large polyp [\u226510\u2009mm] and cancer diagnosis). Adjusted positive predictive values (aPPVs) were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We analysed 384,510 LGIEs; 33.2% were performed on patients aged under 50 and 53.6% on women. Regarding colonoscopies, the unadjusted PPV for cancer was 1.5% (95% CI: 1.4\u20131.5); higher for men than women (1.9% vs. 1.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). The PPV for large polyps was 3.2% (95% CI: 3.1\u20133.2). The highest colonoscopy cancer aPPVs were in the over 50s (1.9%) and in those with rectal bleeding (2.5%) or anaemia (2.1%). Cancer aPPVs for other symptoms were &lt;1% despite representing 54.3% of activity. In patients under 50, aPPVs were 0.4% for cancer and 1.6% for large polyps. Results were similar for sigmoidoscopy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most colonoscopies were performed on patients with low\u2010risk symptoms, where cancer risk was similar to the general population. Cancer and large polyp yield was highest in elderly patients with rectal bleeding or anaemia, although still fell short of FIT\u2010based screening yields.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.18003","type":"journal-article","created":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T04:05:11Z","timestamp":1713413111000},"page":"1589-1603","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Diagnostic yield from symptomatic lower gastrointestinal endoscopy in the UK: A British Society of Gastroenterology analysis using data from the National Endoscopy Database"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4329-8842","authenticated-orcid":false,"given":"David","family":"Beaton","sequence":"first","affiliation":[{"name":"Northumbria NHS Foundation Trust  Newcastle upon Tyne UK"},{"name":"Population Health Sciences Institute, Newcastle University Centre for Cancer Newcastle University  Newcastle\u2010upon\u2010Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9515-1722","authenticated-orcid":false,"given":"Linda","family":"Sharp","sequence":"additional","affiliation":[{"name":"Population Health Sciences Institute, Newcastle University Centre for Cancer Newcastle University  Newcastle\u2010upon\u2010Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liya","family":"Lu","sequence":"additional","affiliation":[{"name":"Population Health Sciences Institute, Newcastle University Centre for Cancer Newcastle University  Newcastle\u2010upon\u2010Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8040-8158","authenticated-orcid":false,"given":"Nigel","family":"Trudgill","sequence":"additional","affiliation":[{"name":"Sandwell &amp; West Birmingham NHS Trust  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6967-9646","authenticated-orcid":false,"given":"Mo","family":"Thoufeeq","sequence":"additional","affiliation":[{"name":"Sheffield Teaching Hospitals NHS Foundation Trust  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0661-7362","authenticated-orcid":false,"given":"Brian","family":"Nicholson","sequence":"additional","affiliation":[{"name":"NIHR Clinical Lecturer, Nuffield Department of Primary Care Health Services University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Rogers","sequence":"additional","affiliation":[{"name":"Weblogik  Ipswich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8401-7023","authenticated-orcid":false,"given":"James","family":"Docherty","sequence":"additional","affiliation":[{"name":"Department of Surgery Raigmore Hospital  Inverness UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Joint Advisory Group on Gastrointestinal Endoscopy Royal College of Physicians  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.\u00a0John","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Glasgow Royal Infirmary  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2270-2495","authenticated-orcid":false,"given":"Thomas","family":"R\u00f6sch","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Endoscopy University Hospital Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9507-0295","authenticated-orcid":false,"given":"Matthew","family":"Rutter","sequence":"additional","affiliation":[{"name":"Population Health Sciences Institute, Newcastle University Centre for Cancer Newcastle University  Newcastle\u2010upon\u2010Tyne UK"},{"name":"North Tees and Hartlepool NHS Foundation Trust  Hartlepool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,18]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"NHS\u2010Digital Urgent suspected cancer referrals. Referral conversion and detection rates April 2009 to March 2021 N.D.R. Service Editor.2021 NHS Digital.https:\/\/www.cancerdata.nhs.uk\/cwt_conversion_and_detection."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro-2020-101538"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.46.1.93"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/jcag\/gwab017"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(20)30157-6"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-022-01919-y"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-300843"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30388-0"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro-2022-102157"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(21)00058-3"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.o1047"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640619841539"},{"key":"e_1_2_9_14_1","unstructured":"The National Endoscopy Database (NED).2021. [cited 2021 10th April].https:\/\/nedpilot.thejag.org.uk\/."},{"key":"e_1_2_9_15_1","unstructured":"NICE.NICE guideline [NG12]: suspected cancer: recognition and referral.2015. [cited 2021 16th Apr].https:\/\/www.nice.org.uk\/guidance\/ng12\/chapter\/Recommendations\u2010organised\u2010by\u2010symptom\u2010and\u2010findings\u2010of\u2010primary\u2010care\u2010investigations#abdominal\u2010symptoms."},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro-2022-102145"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X1401400407"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1927.10502953"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/0470023589"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i35.6474"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.05.009"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1961-4266"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-152-11-201006010-00002"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2208375"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2354.2005.00637.x"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-7-17"},{"issue":"8","key":"e_1_2_9_27_1","first-page":"1179","article-title":"Diagnostic yield of colorectal neoplasia with colonoscopy for abdominal pain, change in bowel habits, and rectal bleeding","volume":"88","author":"Neugut AI","year":"1993","journal-title":"Am J Gastroenterol"},{"issue":"459","key":"e_1_2_9_28_1","first-page":"798","article-title":"Prevalence of lower gastrointestinal symptoms and associated consultation behaviour in a British elderly population determined by face\u2010to\u2010face interview","volume":"50","author":"Chaplin A","year":"2000","journal-title":"Br J Gen Pract"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmh121"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.07.016"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l6090"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2023.04.399"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2022.05.036"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.12.285"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2007.122739"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c3369"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2015-310691"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2022-327985"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15072011"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2021-324856"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2000.02007.x"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-018-0335-z"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/0004563220935622"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.3399\/BJGPO.2022.0036"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-322179"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.18003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T12:10:57Z","timestamp":1748866257000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.18003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,18]]},"references-count":44,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1111\/apt.18003"],"URL":"https:\/\/doi.org\/10.1111\/apt.18003","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,18]]},"assertion":[{"value":"2024-01-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}