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Primary care blood tests before cancer diagnosis: National Cancer Diagnosis Audit data

Cranfield, Ben; Koo, Minjoung Monica; Abel, Gary A; Swann, Ruth; McPhail, Sean; Rubin, Gregory; Lyratzopoulos, Georgios; (2023) Primary care blood tests before cancer diagnosis: National Cancer Diagnosis Audit data. British Journal of General Practice , 73 (727) e95-e103. 10.3399/bjgp.2022.0265. Green open access

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Abstract

Background: Blood tests can support the diagnostic process but how often they are used in cancer patients is unclear. / Aim: To explore use of common blood tests before cancer diagnosis in primary care. / Design and setting: English National Cancer Diagnosis Audit data on 39,752 cancer patients diagnosed in 2018. / Methods: We assessed common blood test use (full blood count (FBC), urea and electrolytes (U&Es), and liver function tests (LFTs)), related variation by patient and symptom group, and associations with the primary care and the diagnostic intervals (PCI, DI). / Results: At least one common blood test was used in 41% of cancer patients. Among tested patients, FBC was used in 95%, U&Es in 88% and LFTs in 74%) Blood testing was less common in women (adjusted odds ratio (aOR) vs men: 0.92, 95%CI: 0.87-0.98) and non-white patients (0.89, 0.82-0.97 vs white) and more common in older patients (1.12, 1.06-1.18 for 70+ vs 50-69 years). Test use varied greatly by cancer-site, (melanoma: 2%, leukaemia 84%). Fewer patients presenting with alarm symptoms alone were tested (24%) than those with non-alarm symptoms alone (50%). Median PCI and DI were longer in tested than non-tested patients (PCI: 10 vs 0; DI: 49 vs 32 days, respectively, p<0.001 for both), including among tested patients with alarm symptoms (PCI: 4 vs 0; DI: 41 vs 22). / Conclusions: Two-fifths of patients subsequently diagnosed with cancer have primary care blood tests. Given variable test use, research is needed on the clinical context in which blood tests are ordered.

Type: Article
Title: Primary care blood tests before cancer diagnosis: National Cancer Diagnosis Audit data
Open access status: An open access version is available from UCL Discovery
DOI: 10.3399/bjgp.2022.0265
Publisher version: https://doi.org/10.3399/BJGP.2022.0265
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third-party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Keywords: Blood tests; cancer; cancer diagnosis; full blood count; liver function tests; primary health care; urea and electrolytes
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10156534
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