{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T13:18:02Z","timestamp":1780492682448,"version":"3.54.1"},"reference-count":33,"publisher":"Royal College of General Practitioners","issue":"765","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"accepted":{"date-parts":[[2025,11,11]]},"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Colorectal cancer-related symptoms are commonly seen in primary care. Understanding variations in symptom management is crucial for timely care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine diagnostic testing patterns for gastrointestinal symptoms associated with colorectal cancer in primary care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and setting<\/jats:title>\n                    <jats:p>Retrospective cohort study using linked primary care data from patients aged \u226540 years presenting with colorectal cancer-related symptoms between 2008 and 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>The proportion of patients receiving diagnostic actions was assessed, including medications, pathology, imaging, colonoscopy, or specialist referral. Differences in testing by socioeconomic status and subsequent colorectal cancer diagnosis were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 70 107 patients, 378 (0.5%) were diagnosed with colorectal cancer within 12 months. Abdominal pain (32%;\n                      <jats:italic>n<\/jats:italic>\n                      = 28 455\/90 059) and diarrhoea (21%;\n                      <jats:italic>n<\/jats:italic>\n                      = 19 071\/90 059) were the most frequent presentations. No investigation or treatment occurred in 20% (change in bowel habit;\n                      <jats:italic>n<\/jats:italic>\n                      = 226\/1106) to 50% (constipation;\n                      <jats:italic>n<\/jats:italic>\n                      = 6028\/12 128; and diarrhoea;\n                      <jats:italic>n<\/jats:italic>\n                      = 7069\/14 122) of patients. Medication-only management was highest for diarrhoea (11%;\n                      <jats:italic>n<\/jats:italic>\n                      = 1547\/14 122) and constipation (23%;\n                      <jats:italic>n<\/jats:italic>\n                      = 2847\/12 128). Blood or imaging tests were most frequent for abdominal pain (36%;\n                      <jats:italic>n<\/jats:italic>\n                      = 7572\/20 956) and abdominal mass (41%;\n                      <jats:italic>n<\/jats:italic>\n                      = 294\/718). Colonoscopy or specialist referral was highest for rectal bleeding (67%;\n                      <jats:italic>n<\/jats:italic>\n                      = 4536\/6772) and change in bowel habit (60%;\n                      <jats:italic>n<\/jats:italic>\n                      = 662\/1106). Investigation likelihood increased with multiple symptoms or repeat visits (odds ratio [OR] 3.40, 95% confidence interval [CI] = 3.16 to 3.65,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Patients aged \u226580 years were significantly less likely to be investigated or referred (OR 0.53, 95% CI = 0.50 to 0.55,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001), and those from more advantaged areas were more likely to be investigated (OR 1.45, 95% CI = 1.38 to 1.53,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Substantial variation in investigating colorectal cancer-related symptoms may contribute to inequities in diagnostic outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3399\/bjgp.2025.0619","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T13:55:14Z","timestamp":1764856514000},"page":"e309-e318","source":"Crossref","is-referenced-by-count":1,"title":["Variations in the investigation of colorectal cancer-related symptoms in Australian primary care: a retrospective cohort study"],"prefix":"10.3399","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6772-0649","authenticated-orcid":false,"given":"Shaoke","family":"Lei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2631-1002","authenticated-orcid":false,"given":"Brent","family":"Venning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Pearce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Emery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"2026052703450983000_76.765.e309.1","unstructured":"Australian Institute of Health and Welfare (2025) Cancer data in Australia. 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