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Theme: Diagnostics & Stratified Medicine
For many types of cancer, survival is lower in the UK than for most European countries. PenCLAHRC is supporting a programme of work on cancer diagnostic tools and guidelines, which includes the projects summarised below:
Diagnostic tools that can predict the risk of cancer in patients with symptoms have been developed and are available for GPs to use in clinical practice. However, there are no summaries of the evidence on whether using these tools improves patient quality of life or survival, and what impact their use might have on NHS resources.
This project, funded by the NIHR Health Technology Assessment programme (NIHR HTA), looks to find out whether GPs have access to these tools and how widely they are used, to evaluate the impact of these tools on the timing of cancer diagnosis, as well as the extent and severity of cancer at diagnosis, and patients’ quality of life and survival.
By researching the efficacy, cost-effectiveness and current use of cancer diagnostic tools, the project aims to aid decision-making in primary care.
PenCLAHRC-supported Professor Willie Hamilton was clinical lead on the 2012-15 update of the NICE referral guidelines for suspected cancer. In partnership with the Royal Devon & Exeter NHS Foundation Trust, this project will evaluate the impact of these guidelines on cancer diagnosis in the UK. PenCLAHRC researcher Dr Obioha Ukoumunne is part of the project, which is funded by Cancer Research UK.
The Early Diagnosis in Cancer Group (chaired by Professor Willie Hamilton) produced a series of studies documenting the predictive power of symptoms in primary care. This work led to the development of tools to inform GP decision-making that form a major part of the evidence base for the current NICE referral guidelines for suspected cancer.
A PenCLAHRC-supported team at the University of Exeter Medical School including Dr Sarah Bailey and Dr Obioha Ukoumunne, were awarded funding by the Department of Health Policy Research Programme, to further explore the risk markers of cancer in primary care.
This project is led by the Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis at Queen Mary, University of London.
Through a large-scale study of 40,000 patient records, the team have found that having a high blood platelet count (called thrombocytosis) is a strong predictor of cancer and should be urgently investigated to save lives. This is the first new symptom of cancer to be discovered in many years and could have a significant impact on primary health care.
If only a conservative estimate of 5% of patients with cancer have thrombocytosis before a cancer diagnosis, one third of them could be diagnosed at least three months earlier if this risk marker was identified. This would equate to 5,500 earlier diagnoses annually. Find out more in this news story: Raised blood platelet levels 'strong predictor' of cancer.
Bailey S, Ukoumunne O, Shephard Liz, Hamilton W. How useful is thrombocytosis in predicting an underlying cancer in primary care? Systematic review protocol. Family Practice 2016; 34:1
Bailey S, Ukoumunne O, Shephard Liz, Hamilton W. Clinical relevance of thrombocytosis in primary care: a prospective cohort study of cancer incidence using English electronic medical records and cancer registry data. British Journal of General Practice 2017