Recognising Colorectal Cancer in Primary Care

Natalia Calanzani, Aina Chang, Marije Van Melle, Merel M. Pannebakker, Garth Funston, Fiona M. Walter* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)
3 Downloads (Pure)


Colorectal cancer (CRC) is the third most common cancer worldwide. Primary care professionals can play an important role in both prevention and early detection of CRC. Most CRCs are attributed to modifiable lifestyle factors, which can be addressed within primary care, and promotion of population-based screening programmes can aid early cancer detection in asymptomatic patients. Primary care professionals have a vital role in clinically assessing patients presenting with symptoms that may indicate cancer, as most patients with CRC first present with symptoms. These assessments are often challenging—many of the symptoms of CRC are non-specific and commonly occur in patients presenting with non-malignant disease. The range of options for investigating symptomatic patients in primary care is rapidly growing. Simple tests, such as faecal immunochemical testing (FIT), are now being used to guide decisions around referral for more invasive tests, such as colonoscopy, while direct access to specialist investigations is also becoming more common. Clinical decision support tools (CDSTs) which calculate cancer risk based on symptomatology, patient characteristics and test results can provide an additional resource to guide decisions on further investigation. This article explores the challenges of CRC prevention and detection from the primary care perspective, discusses current evidence-based approaches for CRC detection used in primary care (with examples from UK guidelines), and highlights emerging research which may likely alter practice in the future.

Original languageEnglish
Pages (from-to)2732–2746
Number of pages15
JournalAdvances in Therapy
Publication statusPublished - 17 Apr 2021

Bibliographical note

This study was supported by the CanTest Collaborative (funded by Cancer Research UK C8640/A23385). No funding or sponsorship was received for the publication of this article.

Data Availability Statement

Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.


  • colorectal cancer
  • early diagnosis
  • faecal immunochemical test
  • primary care


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