Identifying opportunities for timely diagnosis of bladder and renal cancer via abnormal blood tests: a longitudinal linked data study.
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Authors
Mounce, Luke
Abel, Gary A
Singh, Hardeep
Hamilton, Willie
Lyratzopoulos, Georgios
Publication Date
2022-01Journal Title
Br J Gen Pract
ISSN
0960-1643
Publisher
Royal College of General Practitioners
Volume
72
Issue
714
Pages
e19-e25
Type
Article
This Version
VoR
Physical Medium
Electronic-Print
Metadata
Show full item recordCitation
Zhou, Y., Walter, F., Mounce, L., Abel, G. A., Singh, H., Hamilton, W., Stewart, G., & et al. (2022). Identifying opportunities for timely diagnosis of bladder and renal cancer via abnormal blood tests: a longitudinal linked data study.. Br J Gen Pract, 72 (714), e19-e25. https://doi.org/10.3399/BJGP.2021.0282
Abstract
BACKGROUND: Understanding pre-diagnostic test use could reveal diagnostic windows where more timely evaluation for cancer may be indicated. AIM: To examine pre-diagnostic patterns of results of abnormal blood tests in patients with bladder and renal cancer. DESIGN AND SETTING: A retrospective cohort study using primary care and cancer registry data on patients with bladder and renal cancer who were diagnosed between April 2012 and December 2015 in England. METHOD: The rates of patients with a first abnormal result in the year before cancer diagnosis, for 'generic' (full blood count components, inflammatory markers, and calcium) and 'organ-specific' blood tests (creatinine and liver function test components) that may lead to subsequent detection of incidental cancers, were examined. Poisson regression was used to detect the month during which the cohort's rate of each abnormal test started to increase from baseline. The proportion of patients with a test found in the first half of the diagnostic window was examined, as these 'early' tests might represent opportunities where further evaluation could be initiated. RESULTS: Data from 4533 patients with bladder and renal cancer were analysed. The monthly rate of patients with a first abnormal test increased towards the time of cancer diagnosis. Abnormalities of both generic (for example, high inflammatory markers) and organ-specific tests (for example, high creatinine) started to increase from 6-8 months pre-diagnosis, with 25%-40% of these patients having an abnormal test in the 'early half' of the diagnostic window. CONCLUSION: Population-level signals of bladder and renal cancer can be observed in abnormalities in commonly performed primary care blood tests up to 8 months before diagnosis, indicating the potential for earlier diagnosis in some patients.
Keywords
bladder cancer, diagnostic tests, routine, early detection of cancer, primary health care, renal cancer, test utilisation
Identifiers
External DOI: https://doi.org/10.3399/BJGP.2021.0282
This record's URL: https://www.repository.cam.ac.uk/handle/1810/334066
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