Skip to content

Predictive value of inflammatory markers for cancer diagnosis in primary care: a prospective cohort study using electronic health records

Research output: Contribution to journalArticle

Standard

Predictive value of inflammatory markers for cancer diagnosis in primary care : a prospective cohort study using electronic health records. / Watson, Jessica; Salisbury, Chris; Banks, Jonathan; Whiting, Penny; Hamilton, Willie.

In: British Journal of Cancer, Vol. 120, No. 11, 28.05.2019, p. 1045-1051.

Research output: Contribution to journalArticle

Harvard

APA

Vancouver

Author

Bibtex

@article{978814aeb03d4b0eabc4982e13641766,
title = "Predictive value of inflammatory markers for cancer diagnosis in primary care: a prospective cohort study using electronic health records",
abstract = "BackgroundEarly identification of cancer in primary care is important and challenging. This study examined the diagnostic utility of inflammatory markers (C-reactive protein, erythrocyte sedimentation rate and plasma viscosity) for cancer diagnosis in primary care. MethodsCohort study of 160,000 patients with inflammatory marker testing in 2014, plus 40,000 untested matched controls, using Clinical Practice Research Datalink (CPRD), with Cancer Registry linkage. Primary outcome was one-year cancer incidence. Results Primary care patients with a raised inflammatory marker have a one-year cancer incidence of 3.53{\%} (95{\%} CI 3.37-3.70), compared to 1.50{\%} (1.43-1.58) in those with normal inflammatory markers, and 0.97{\%} (0.87-1.07) in untested controls. Cancer risk is greater with higher inflammatory marker levels, with older age and in men; risk rises further when a repeat test is abnormal, but falls if it normalises. Men over 50 and women over 60 with raised inflammatory markers have a cancer risk which exceeds the 3{\%} NICE threshold for urgent investigation. Sensitivities for cancer were 46.1{\%} for CRP, 43.6{\%} ESR and 49.7{\%} for PV. Conclusion Cancer should be considered in patients with raised inflammatory markers. However, inflammatory markers have a poor sensitivity for cancer and are therefore not useful as ‘rule-out’ test.",
keywords = "Diagnosis, cancer, primary health care, electronic health records, C-Reactive protein, erythrocyte sedimentation, biomarkers",
author = "Jessica Watson and Chris Salisbury and Jonathan Banks and Penny Whiting and Willie Hamilton",
year = "2019",
month = "5",
day = "28",
doi = "10.1038/s41416-019-0458-x",
language = "English",
volume = "120",
pages = "1045--1051",
journal = "British Journal of Cancer",
issn = "0007-0920",
publisher = "Springer Nature",
number = "11",

}

RIS - suitable for import to EndNote

TY - JOUR

T1 - Predictive value of inflammatory markers for cancer diagnosis in primary care

T2 - British Journal of Cancer

AU - Watson, Jessica

AU - Salisbury, Chris

AU - Banks, Jonathan

AU - Whiting, Penny

AU - Hamilton, Willie

PY - 2019/5/28

Y1 - 2019/5/28

N2 - BackgroundEarly identification of cancer in primary care is important and challenging. This study examined the diagnostic utility of inflammatory markers (C-reactive protein, erythrocyte sedimentation rate and plasma viscosity) for cancer diagnosis in primary care. MethodsCohort study of 160,000 patients with inflammatory marker testing in 2014, plus 40,000 untested matched controls, using Clinical Practice Research Datalink (CPRD), with Cancer Registry linkage. Primary outcome was one-year cancer incidence. Results Primary care patients with a raised inflammatory marker have a one-year cancer incidence of 3.53% (95% CI 3.37-3.70), compared to 1.50% (1.43-1.58) in those with normal inflammatory markers, and 0.97% (0.87-1.07) in untested controls. Cancer risk is greater with higher inflammatory marker levels, with older age and in men; risk rises further when a repeat test is abnormal, but falls if it normalises. Men over 50 and women over 60 with raised inflammatory markers have a cancer risk which exceeds the 3% NICE threshold for urgent investigation. Sensitivities for cancer were 46.1% for CRP, 43.6% ESR and 49.7% for PV. Conclusion Cancer should be considered in patients with raised inflammatory markers. However, inflammatory markers have a poor sensitivity for cancer and are therefore not useful as ‘rule-out’ test.

AB - BackgroundEarly identification of cancer in primary care is important and challenging. This study examined the diagnostic utility of inflammatory markers (C-reactive protein, erythrocyte sedimentation rate and plasma viscosity) for cancer diagnosis in primary care. MethodsCohort study of 160,000 patients with inflammatory marker testing in 2014, plus 40,000 untested matched controls, using Clinical Practice Research Datalink (CPRD), with Cancer Registry linkage. Primary outcome was one-year cancer incidence. Results Primary care patients with a raised inflammatory marker have a one-year cancer incidence of 3.53% (95% CI 3.37-3.70), compared to 1.50% (1.43-1.58) in those with normal inflammatory markers, and 0.97% (0.87-1.07) in untested controls. Cancer risk is greater with higher inflammatory marker levels, with older age and in men; risk rises further when a repeat test is abnormal, but falls if it normalises. Men over 50 and women over 60 with raised inflammatory markers have a cancer risk which exceeds the 3% NICE threshold for urgent investigation. Sensitivities for cancer were 46.1% for CRP, 43.6% ESR and 49.7% for PV. Conclusion Cancer should be considered in patients with raised inflammatory markers. However, inflammatory markers have a poor sensitivity for cancer and are therefore not useful as ‘rule-out’ test.

KW - Diagnosis

KW - cancer

KW - primary health care

KW - electronic health records

KW - C-Reactive protein

KW - erythrocyte sedimentation

KW - biomarkers

UR - http://www.scopus.com/inward/record.url?scp=85064840568&partnerID=8YFLogxK

U2 - 10.1038/s41416-019-0458-x

DO - 10.1038/s41416-019-0458-x

M3 - Article

VL - 120

SP - 1045

EP - 1051

JO - British Journal of Cancer

JF - British Journal of Cancer

SN - 0007-0920

IS - 11

ER -