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Last reviewed: 16 Mar 2025
Last updated: 01 Nov 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • family history

Other diagnostic factors

  • rectal bleeding
  • mucus discharge
  • weight loss
  • tenesmus
  • change in bowel habit
  • symptoms and signs of anaemia

Risk factors

  • increasing age
  • family history of colorectal cancer or colorectal polyps
  • previous history of polyps
  • male sex
  • acromegaly

Diagnostic investigations

1st investigations to order

  • colonoscopy
  • CT colonography
  • chromoendoscopy
  • histology

Emerging tests

  • virtual chromoendoscopy techniques
  • artificial intelligence-assisted colonoscopy
  • capsule endoscopy

Treatment algorithm

Contributors

Authors

Edward T. Pring, FRCS, PhD

Post CCT Fellow

St Mark’s the National Bowel Hospital

London

UK

Disclosures

ETP declares that he has no competing interests.

Jason Rai, MRCS, MMedEd

General Surgery Specialty Registrar

Oxford Deanery

Clinical Research Fellow

St Mark’s the National Bowel Hospital

London

UK

Disclosures

JR declares that he has no competing interests.

Allison Wallace, MRCS, MSc

General Surgery Specialty Registrar

Oxford Deanery

Clinical Research Fellow

St Mark’s the National Bowel Hospital

London

UK

Disclosures

AW declares that she has no competing interests.

Laura E. Gould, MRCS

General Surgery Specialty Registrar

North East and Central London Deanery

Clinical Research Fellow

St Mark’s the National Bowel Hospital

London

UK

Disclosures

LG declares that she has no competing interests.

Dinh V. C. Mai, MRCS

General Surgery Specialty Registrar

Oxford Deanery

Clinical Research Fellow at St Mark’s the National Bowel Hospital

London

UK

Disclosures

DM declares that she has no competing interests.

Ioanna Drami, MRCS, MSc, BSc

General Surgery Specialty Registrar

North East and Central London Deanery

Clinical Research Fellow at St Mark’s the National Bowel Hospital

London

UK

Disclosures

ID declares that she has no competing interests.

John T. Jenkins, MD

Consultant Colorectal Surgeon

St Mark’s the National Bowel Hopital

London

UK

Disclosures

JTJ declares that he has no competing interests.

Acknowledgements

Mr Edward T. Pring, Mr Jason Rai, Miss Alison Wallace, Miss Laura E. Gould, Mr Dinh V. C. Mai, Miss Ioanna Drami and Mr John T. Jenkins would like to gratefully acknowledge Mr Phil Tozer and Mr George Malietzis previous contributors to this topic.

Disclosures

PT and GM declares that they have no competing interests.

Peer reviewers

John Anderson, FRCS

Consultant Colorectal Surgeon

Glasgow Royal Infirmary

Glasgow

UK

Disclosures

JA declares that he has no competing interests.

Sharon Stein, MD

Assistant Professor of Surgery

Division of Colon and Rectal Surgery

University Hospital Case Medical Center

Cleveland

OH

Disclosures

SS received a fee for educational courses on laparoscopic surgery, paid for in part by Covidien, Olympus, and Applied Medical.

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