Incidence of ‘Low-Risk but Not No-Risk’ Features of Cancer Prior to High-Risk Feature Occurrence: An Observational Cohort Study in Primary Care
Diagnosing cancer may be expedited by decreasing referral risk threshold. Clinical Practice Research Datalink participants (≥40 years) had a positive predictive value (PPV) ≥3% feature for breast, lung, colorectal, oesophagogastric, pancreatic, renal, bladder, prostatic, ovarian, endometrial or lary...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-08-01
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| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/15/15/3936 |
| _version_ | 1797586960461594624 |
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| author | Sarah F. Moore Sarah J. Price Jennifer Bostock Richard D. Neal Willie Hamilton |
| author_facet | Sarah F. Moore Sarah J. Price Jennifer Bostock Richard D. Neal Willie Hamilton |
| author_sort | Sarah F. Moore |
| collection | DOAJ |
| description | Diagnosing cancer may be expedited by decreasing referral risk threshold. Clinical Practice Research Datalink participants (≥40 years) had a positive predictive value (PPV) ≥3% feature for breast, lung, colorectal, oesophagogastric, pancreatic, renal, bladder, prostatic, ovarian, endometrial or laryngeal cancer in 2016. The numbers of participants with features representing a 1–1.99% or 2–2.99% PPV for same cancer in the previous year were reported, alongside the time difference between meeting the ≥3% criteria and the lower threshold criteria. A total of 8616 participants had a PPV ≥3% feature, of whom 365 (4.2%) and 1147 (13.3%), respectively, met 2–2.99% and 1–1.99% criteria in the preceding year. The median time difference was 131 days (Interquartile Range (IQR) 27 to 256) for the 2–2.99% band and 179 days (IQR 58 to 289) for the 1–1.99% band. Results were heterogeneous across cancer sites. For some cancers, participants may progress from presenting lower- to higher-risk features before meeting urgent referral criteria; however, this was not usually the case. The details of specific features across multiple cancer sites will allow for a tailored approach to future reductions in referral thresholds, potentially improving the efficiency of urgent cancer referrals for the benefit both of individuals and the National Health Service (NHS). |
| first_indexed | 2024-03-11T00:30:35Z |
| format | Article |
| id | doaj.art-9c30c68bee184f3bacead1abd91a0095 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T00:30:35Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-9c30c68bee184f3bacead1abd91a00952023-11-18T22:43:23ZengMDPI AGCancers2072-66942023-08-011515393610.3390/cancers15153936Incidence of ‘Low-Risk but Not No-Risk’ Features of Cancer Prior to High-Risk Feature Occurrence: An Observational Cohort Study in Primary CareSarah F. Moore0Sarah J. Price1Jennifer Bostock2Richard D. Neal3Willie Hamilton4Faculty of Health and Life Sciences, University of Exeter, Exeter EX2 4TH, UKFaculty of Health and Life Sciences, University of Exeter, Exeter EX2 4TH, UKPolicy Research Unit in Cancer Awareness, Screening and Early Diagnosis, Queen Mary University of London, Mile End Rd., London E1 4NS, UKFaculty of Health and Life Sciences, University of Exeter, Exeter EX2 4TH, UKFaculty of Health and Life Sciences, University of Exeter, Exeter EX2 4TH, UKDiagnosing cancer may be expedited by decreasing referral risk threshold. Clinical Practice Research Datalink participants (≥40 years) had a positive predictive value (PPV) ≥3% feature for breast, lung, colorectal, oesophagogastric, pancreatic, renal, bladder, prostatic, ovarian, endometrial or laryngeal cancer in 2016. The numbers of participants with features representing a 1–1.99% or 2–2.99% PPV for same cancer in the previous year were reported, alongside the time difference between meeting the ≥3% criteria and the lower threshold criteria. A total of 8616 participants had a PPV ≥3% feature, of whom 365 (4.2%) and 1147 (13.3%), respectively, met 2–2.99% and 1–1.99% criteria in the preceding year. The median time difference was 131 days (Interquartile Range (IQR) 27 to 256) for the 2–2.99% band and 179 days (IQR 58 to 289) for the 1–1.99% band. Results were heterogeneous across cancer sites. For some cancers, participants may progress from presenting lower- to higher-risk features before meeting urgent referral criteria; however, this was not usually the case. The details of specific features across multiple cancer sites will allow for a tailored approach to future reductions in referral thresholds, potentially improving the efficiency of urgent cancer referrals for the benefit both of individuals and the National Health Service (NHS).https://www.mdpi.com/2072-6694/15/15/3936cancerearly diagnosisreferralsprimary care |
| spellingShingle | Sarah F. Moore Sarah J. Price Jennifer Bostock Richard D. Neal Willie Hamilton Incidence of ‘Low-Risk but Not No-Risk’ Features of Cancer Prior to High-Risk Feature Occurrence: An Observational Cohort Study in Primary Care Cancers cancer early diagnosis referrals primary care |
| title | Incidence of ‘Low-Risk but Not No-Risk’ Features of Cancer Prior to High-Risk Feature Occurrence: An Observational Cohort Study in Primary Care |
| title_full | Incidence of ‘Low-Risk but Not No-Risk’ Features of Cancer Prior to High-Risk Feature Occurrence: An Observational Cohort Study in Primary Care |
| title_fullStr | Incidence of ‘Low-Risk but Not No-Risk’ Features of Cancer Prior to High-Risk Feature Occurrence: An Observational Cohort Study in Primary Care |
| title_full_unstemmed | Incidence of ‘Low-Risk but Not No-Risk’ Features of Cancer Prior to High-Risk Feature Occurrence: An Observational Cohort Study in Primary Care |
| title_short | Incidence of ‘Low-Risk but Not No-Risk’ Features of Cancer Prior to High-Risk Feature Occurrence: An Observational Cohort Study in Primary Care |
| title_sort | incidence of low risk but not no risk features of cancer prior to high risk feature occurrence an observational cohort study in primary care |
| topic | cancer early diagnosis referrals primary care |
| url | https://www.mdpi.com/2072-6694/15/15/3936 |
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