The Incidence and Outcome of Rectal Bleeding in General Practice

The objective of the studies reported in this paper was to determinethe incidence as well as the final diagnostic outcome of rectalbleeding presenting in general practice. Because of the widevariety observed in incidence rates among 83 general practitioners(GPs) in the first study (A) an additional study (B) was undertaken.In study B with 10 GPs special efforts were made to maximizethe catchment rate. The mean ‘consultation incidence rate’was 7 per 1000 people per year. A follow-up period of at least1 year was applied to establish the final diagnostic conclusion.Occurrence of colorectal cancer was found in 3% of patientswith rectal bleeding. This may represent an overestimation ofthe prior probability since there was a selection in favourof patients with clinically relevant rectal bleeding. In about90% of patients rectal bleeding was related to minor ailmentsor self-limiting disorders. Further study on predictive valuesof (combinations of) other signs and symptoms is necessary todevelop clinical recommendations.