A common blood test could help to improve cancer diagnosis for those with stomach pain or bloating according to a study led by University College London that was recently published in PLOS Medicine.
The study
Using anonymized data from the Clinical Practice Research Datalink (CPRD), collected from a network of GP practices across the UK between 2007 and 2016, this study analyzed data from over 400,000 people aged 30 years old and over who had visited a general practitioner (GP) due to stomach pain and more than 50,000 who had bloating, two-thirds of these people had blood testing after their appointment. In the UK, people are given an urgent cancer referral to see a specialist from a GP if their risk of cancer is higher than 3%; and those over the age of 60 with stomach pain and/or bloating are given a referral regardless of their blood test results.
Blood tests may help diagnosis
The analysis revealed that in 19 of the commonly used blood tests, abnormal results were linked to a higher risk of being diagnosed with cancer within one year’s time. The researchers estimated that if these abnormal results were taken into account, there would have been a 16% increase in those with undiagnosed cancer who were given an urgent referral compared to assessment based on symptoms, gender, and age alone. This translates to an extra 6 people with undiagnosed cancer being referred out of 1,000 who visited a general practitioner with stomach pain or bloating, on top of 40 people with cancer being urgently referred already without using blood test results (*).
“Our study suggests we can improve cancer detection with blood tests that are already available and that are routinely given to patients with non-specific symptoms whose cause is unclear. This could be an efficient, affordable way to improve early cancer diagnosis and in some cases increase the likelihood of successful treatment,” said lead author Dr Meena Rafiq, of the UCL Department of Behavioural Science & Health. “Given that in practice it may be challenging for GPs to interpret a range of blood test data, our study points to the need for an automated tool that could assess cancer risk based on multiple variables.”
What they found
The analysis also revealed that 1 in 50 people who went to see a GP for stomach pain were diagnosed with cancer within the next 12 months, and the same proportion of people reporting bloating were also diagnosed with cancer within a year. The risk of cancer was estimated to be 3.1% for men in their 60s reporting stomach pain, rising to 8.6% for men in their 80s with this symptom. For women in these age groups, their risk was 3.1%, rising to 6.1%.
Additionally, among those between the ages of 30 and 59 years old, abdominal pain or bloating, anemia, low albumin, raised platelets, abnormal ferritin, and increased inflammatory markers strongly predicted a risk of undiagnosed cancer. For example, among women aged 50 to 59 years old with abdominal bloating, pre-blood test cancer risk of 1.6% increased to 10% with raised ferritin, to 9% with low albumin, to 8% with raised platelets, to 6% with raised inflammatory markers and to 4% with anemia.
Overall, bowel cancer was the most common form of cancer which was followed by prostate and pancreatic cancer in men, while in women bowel cancer was followed by breast and ovarian cancer.
“Half of all people with as-yet-undetected cancer will first go to the doctor with vague symptoms that can be challenging to diagnose. Many of these patients are investigated in primary care with commonly used blood tests that could help to identify which patients are most likely to have underlying cancer and should be prioritised for referral,” said Dr. Rafiq. “This research shows these common tests can substantially enhance assessment of cancer risk.”
(*) If any patient had one or more than one blood test that increased their risk to above 3% (and they would not have been referred based on their age, sex, and symptom alone) they were included as an extra urgent referral.
This article was written at the WHN News Desk
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References/Sources/Materials provided by:
https://www.ucl.ac.uk/news/2024/jul/common-blood-tests-could-improve-early-cancer-diagnosis
