{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T14:19:20Z","timestamp":1782397160640,"version":"3.54.5"},"reference-count":30,"publisher":"Royal College of General Practitioners","issue":"658","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Incidences of colorectal cancer (CRC) and inflammatory bowel disease (IBD) are increasing in those aged &lt;50 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To identify and quantify clinical features in primary care of CRC\/IBD in those aged &lt;50 years. This study considered the two conditions together and aimed to determine which younger patients, presenting in primary care with symptoms, would benefit from investigation for potentially serious colorectal disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>Matched case-control study using primary care records from the Clinical Practice Research Datalink, UK.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Incident cases (aged &lt;50 years) of CRC (<jats:italic>n<\/jats:italic> = 1661) and IBD (<jats:italic>n<\/jats:italic> = 9578) diagnosed between 2000 and 2013 were each matched with up to three controls (<jats:italic>n<\/jats:italic> = 3979 CRC; <jats:italic>n<\/jats:italic> = 22 947 IBD). Odds ratios (OR) and positive predictive values (PPV) were estimated for features of CRC\/IBD in the year before diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten features were independently associated with CRC\/IBD (all <jats:italic>P<\/jats:italic>&lt;0.001): rectal bleeding, change in bowel habit, diarrhoea, raised inflammatory markers, thrombocytosis, abdominal pain, low mean cell volume (MCV), low haemoglobin, raised white cell count, and raised hepatic enzymes. PPVs were &gt;3% for rectal bleeding with diarrhoea, thrombocytosis, low MCV, low haemoglobin or raised inflammatory markers; for change in bowel habit with low MCV, thrombocytosis or low haemoglobin; and for diarrhoea with thrombocytosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study quantified the risk of serious bowel disease in symptomatic patients aged &lt;50 years in primary care. Rectal bleeding and change in bowel habit are strongly predictive of CRC\/IBD when combined with abnormal haematology. 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