# Rectal Bleeding in Patients Over Age 60 Years Requires Follow-up



## JeanG (Oct 20, 1999)

The url for this article is: http://www.medscape.com/reuters/prof/2000/...024clin006.html Rectal Bleeding in Patients Over Age 60 Years Requires Follow-Up --------------------------------------------------------------------------------WESTPORT, CT (Reuters Health) Oct 25 - Patients with rectal bleeding should seek medical advice, especially if they are more than 60 years old, report investigators in Belgium. Dr. Frank Buntinx of the Catholic University of Leuven, and associates analyzed data from the Belgian sentinel practices network, identifying all patients with rectal bleeding and those with colorectal cancer diagnosed between 1993 and 1994. For 18 to 30 months, they followed up with the practices where patients reported rectal bleeding. Of 106 patients with colorectal cancer, 31 had visited their doctor with rectal bleeding in the weeks before being diagnosed, yielding a sensitivity of 29.2%, they report in the October 21st issue of the British Medical Journal. Conversely, of 386 patients presenting with rectal bleeding, 27 developed colorectal cancer during the follow-up period, yielding a total positive predictive value of 7.0%. The positive predictive value increased with age, ranging from less than 2% for those below the age of 60 years, to 11.2% for those between 60 and 69 years and 21.2% for those aged 70 to 79 years. The positive predictive value also increased for symptoms of spasms, fatigue, weight loss, and palpable tumor. Dr. Buntinx and his colleagues conclude that "more thorough investigation" is needed when rectal bleeding occurs in patients over the age of 60 years or when bleeding is accompanied by fatigue, weight loss, or a palpable tumor. BMJ 2000;321:998-999.


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