Table 3 Clinical value of symptoms and signs in patients presenting with rectal bleeding in terms of colorectal cancer

From: Diagnostic accuracy systematic review of rectal bleeding in combination with other symptoms, signs and tests in relation to colorectal cancer

  No of studies a No of patients Sens (95% CI) Spec (95% CI) Pooled PLR (95% CI)
Patient characteristics
 Male 5 1253 0.58 (0.48–0.67) 0.52 (0.48–0.56) 1.21 (1.00–1.46)
 Age <40 yearsb 2 745 0.03 (0.00–0.16) 0.73 (0.69–0.76) 0.32 (0.05–2.21)
 Age 40–59 yearsb 4 1387 0.09 (0.04–0.19) 0.79 (0.70–0.86) 0.41 (0.18–0.90)
 Age 60 yearsb 6 1760 0.66 (0.45–0.83) 0.76 (0.68–0.83) 2.79 (2.00–3.90)
 Family history colorectal cancer 3 886 0.15 (0.06–0.28) 0.85 (0.82–0.87) 1.05 (0.16–6.88)
Symptoms
 Dark red bloodc 4 949 0.22 (0.13–0.34) 0.84 (0.69–0.93) 1.37 (0.59–3.30)
 Weight loss 7 1737 0.17 (0.06–0.37) 0.91 (0.83–0.96) 1.89 (1.03–3.07)
 Abdominal pain 7 1739 0.25 (0.04–0.62) 0.73 (0.52–0.89) 0.94 (0.19–1.59)
 Changed bowel habit 5 1254 0.62 (0.18–0.94) 0.68 (0.53–0.80) 1.92 (0.54–3.57)
 Blood mixed with the stool 5 1225 0.40 (0.04–0.93) 0.81 (0.23–0.98) 1.91 (0.75–5.51)
 Previous history of rectal bleedingd 2 425 0.30 (0.05–0.41) 0.66 (0.63–0.71) 0.58 (0.14–1.41)
 Perianal symptoms – pain on defecation 2 411 0.22 (0.13–0.36) 0.41 (0.22–0.78) 0.49 (0.25–0.97)
 Perianal symptoms – itch/eczema 2 414 0.17 (0.07–0.33) 0.87 (0.73–0.95) 1.31 (0.25–6.21)
Signs and diagnostic tests
 Rectal palpation – haemorrhoid 2 354 0.24 (0.09–0.45) 0.73 (0.46–0.91) 0.51 (0.09–2.97)
 Anaemia (Hb ♀<12.0 g per 100 ml ♂<13.3 g per 100 ml) 2 700 0.17 (0.05–0.35) 0.95 (0.93–0.96) 3.67 (1.30–10.35)
  1. Abbreviations: CI=confidence interval; Hb, haemoglobin; PLR=positive likelihood ratio.
  2. a Norrelund and Norrelund (1996) consists of two independent sub-studies, and therefore are independently assessed. In the column ‘no of studies’ these two substudies are counted as two separate studies.
  3. b There is a slight age overlap between the individual studies.
  4. c The reference category of dark red blood consists of patients having bright red blood or a colour in between.
  5. d The reference category of previous history of rectal bleeding consists of patients having a first episode of rectal bleeding.