Trends in primary care blood tests prior to lung and colorectal cancer diagnosis-A retrospective cohort study using linked Australian data

Rafiq, M; Drosdowsky, A; Solomon, B; Alexander, M; Gibbs, P; Wright, G; Yeung, JM; Lyratzopoulos, G; Emery, J

Author(s): Rafiq, M; Drosdowsky, A; Solomon, B; Alexander, M; Gibbs, P; Wright, G; Yeung, JM; Lyratzopoulos, G; Emery, J;
Details: Publication Year 2024-07,Volume 13,Issue #14,Page e70006
Journal Title: Cancer Medicine
Abstract: INTRODUCTION: Abnormal results in common blood tests may occur several months before lung cancer (LC) and colorectal cancer (CRC) diagnosis. Identifying early blood markers of cancer and distinct blood test signatures could support earlier diagnosis in general practice. METHODS: Using linked Australian primary care and hospital cancer registry data, we conducted a cohort study of 855 LC and 399 CRC patients diagnosed between 2001 and 2021. Requests and results from general practice blood tests (six acute phase reactants [APR] and six red blood cell indices [RBCI]) were examined in the 2 years before cancer diagnosis. Poisson regression models were used to estimate monthly incidence rates and examine pre-diagnostic trends in blood test use and abnormal results prior to cancer diagnosis, comparing patterns in LC and CRC patients. RESULTS: General practice blood test requests increase from 7 months before CRC and 6 months before LC diagnosis. Abnormalities in many APR and RBCI tests increase several months before cancer diagnosis, often occur prior to or in the absence of anaemia (in 51% of CRC and 81% of LC patients with abnormalities), and are different in LC and CRC patients. CONCLUSIONS: This study demonstrates an increase in diagnostic activity in Australian general practice several months before LC and CRC diagnosis, indicating potential opportunities for earlier diagnosis. It identifies blood test abnormalities and distinct signatures that are early markers of LC and CRC. If combined with other pre-diagnostic information, these blood tests have potential to support GPs in prioritising patients for cancer investigation of different sites to expedite diagnosis.
Publisher: Wiley
Keywords: Humans; *Colorectal Neoplasms/diagnosis/blood/epidemiology; Australia/epidemiology; *Lung Neoplasms/blood/diagnosis/epidemiology; Male; Female; Retrospective Studies; *Primary Health Care; Aged; Middle Aged; *Hematologic Tests/methods/statistics & numerical data; Early Detection of Cancer/methods; Registries; Biomarkers, Tumor/blood; Adult; Incidence; Aged, 80 and over; blood tests; colorectal cancer; early diagnosis; general practice; lung cancer
Research Division(s): Personalised Oncology
PubMed ID: 39001673
Publisher's Version: https://doi.org/10.1002/cam4.70006
Open Access at Publisher's Site: https://doi.org/10.1002/cam4.70006
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-07-26 09:23:00

Last Modified: 2024-08-23 03:12:16