Abdominal investigations in the year preceding a diagnosis of abdominal cancer: A register-based cohort study in Denmark

Jessen, Nanna Holt; Jensen, Henry; Falborg, Alina Zalounina; Glerup, Henning; Grønbæk, Henning; Vedsted, Peter

doi:10.1016/j.canep.2021.101926

Cited by 5 publications

(16 citation statements)

References 35 publications

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“…763 studies were initially identified, of which 28 were included in the final review ( Fig. 2 ) [10] , [11] , [12] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] . All but four of the selected studies were carried out in Denmark or the UK, while the four remaining studies were set in Germany, Sweden, Australia, and the Netherlands.…”

Section: Resultsmentioning

confidence: 99%

“…The longest reported diagnostic windows (for all patients or at least a subgroup of patients) were four years (43–48 months) pre-diagnosis for all brain tumours combined [30] , three years for multiple myeloma [12] , and two years for colorectal cancer [10] , [17] , [18] , [27] , and benign brain tumours [24] , [37] . Diagnostic windows of between six to 12 months were reported for lung cancer [22] , [25] , [35] , sarcoma [16] , [31] , bladder and kidney cancers combined [15] , childhood/ adolescent lymphoma and leukaemia [31] , [37] , malignant brain cancer [11] , liver [34] , and gall bladder/ biliary tract cancer [34] .…”

Section: Resultsmentioning

confidence: 99%

“…Reported diagnostic windows were shortest (i.e. all under six months) for childhood/adolescent bone cancers [31] , [37] , adolescent germ cell tumours [31] , oesophageal cancer [34] , gastric cancer [34] , pancreatic cancer [34] , prostate cancer [19] , [25] , [38] , breast cancer [19] , [25] , [32] , [38] , [39] , malignant melanoma [25] , [26] , [31] , [38] , endometrial cancer [34] , ovarian cancer [34] , and gynaecological cancers combined [38] .…”

Section: Resultsmentioning

confidence: 99%

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Does changing healthcare use signal opportunities for earlier detection of cancer? A review of studies using information from electronic patient records

White

Renzi

Rafiq

et al. 2022

Cancer Epidemiology

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Background It has been proposed that changes in healthcare use before cancer diagnosis could signal opportunities for quicker detection, but systematic appreciation of such evidence is lacking. We reviewed studies examining pre-diagnostic changes in healthcare utilisation (e.g. rates of GP or hospital consultations, prescriptions or diagnostic tests) among patients subsequently diagnosed with cancer. Methods We identified studies through Pubmed searches complemented by expert elicitation. We extracted information on the earliest time point when diagnosis could have been possible for at least some cancers, together with variation in the length of such ‘diagnostic windows’ by tumour and patient characteristics. Results Across twenty-eight studies, changes in healthcare use were observable at least six months pre-diagnosis for many common cancers, and potentially even earlier for colorectal cancer, multiple myeloma and brain tumours. Early changes were also identified for brain and colon cancer sub-sites. Conclusion Changing healthcare utilisation patterns before diagnosis indicate that future improvements in diagnostic technologies or services could help to shorten diagnostic intervals for cancer. There is greatest potential for quicker diagnosis for certain cancer types and patient groups, which can inform priorities for the development of decision support tools.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Does changing healthcare use signal opportunities for earlier detection of cancer? A review of studies using information from electronic patient records

White

Renzi

Rafiq

et al. 2022

Cancer Epidemiology

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“…The present findings of increases in diagnostic investigations and hospital contacts are similar to previous studies [ 10–12 ] on healthcare use prior to a cancer diagnosis. Further, a recent Danish study on 11 abdominal cancer types demonstrated increased rates of abdominal ultrasound and CT scans from three to five months before a pancreatic cancer diagnosis [ 9 ]. Singh et al.…”

Section: Discussionmentioning

confidence: 99%

“…General practice is the place of first presentation for 70–75% of patients with pancreatic cancer in the UK and France, and 85% in Denmark [ 3 , 4 , 8 ]. A recent Danish study found an increase in abdominal imaging from up to six months before a pancreatic cancer diagnosis [ 9 ], and it is well established that cancer patients have higher healthcare use from 6 to 12 months before the cancer is diagnosed [ 10 , 11 ]. This can be seen as a proxy for symptom presentation and the actions taken by healthcare professionals [ 10–12 ].…”

Section: Introductionmentioning

confidence: 99%

Healthcare use in the year preceding a diagnosis of pancreatic cancer: a register-based cohort study in Denmark

Rasmussen¹,

Virgilsen²,

Fristrup

et al. 2022

Scandinavian Journal of Primary Health Care

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Objective To describe the use of healthcare prior to a diagnosis of pancreatic cancer in Denmark. Design A population-based cohort study using prospectively recorded data from Danish National Health Registries. Setting Danish general practice and hospitals. Subjects A total of 5926 patients diagnosed with pancreatic cancer in 2012–2018 and 59,260 matched references without pancreatic cancer from the Danish general population. Main outcome measures The monthly frequency of healthcare use (contacts and tests in general practice and contacts and diagnostic investigations in hospitals) during the 12 months preceding the pancreatic cancer diagnosis and a corresponding index date assigned to the references. Results Compared to the references, the patients had increased contacts and diagnostic tests, especially blood glucose testing, in general practice from 7 to 12 months before diagnosis. Hospital contacts and diagnostic imaging increased from 5 months before the diagnosis. Conclusions The pattern of increasing healthcare contacts before a diagnosis of pancreatic cancer may represent a window of opportunity to diagnose pancreatic cancer earlier. The increased use of blood glucose test in general practice may represent an important sign of an underlying disease. Key points Pancreatic cancer is a rapidly progressing and highly lethal disease. Focus on early diagnosis is essential to improve the prognosis. Patients with pancreatic cancer had increased number of healthcare contacts from 7 months before the diagnosis. Patients with pancreatic cancer had increased number of blood glucose tests taken throughout almost the entire year before the diagnosis. The results may indicate that a window of opportunity exists to diagnose pancreatic cancer earlier.

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Understanding symptom contribution to sex inequality in bladder and renal cancer stage at diagnosis

Zhou,

Lyratzopoulos,

Rajan

et al. 2024

BJUI Compass

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BackgroundUnderstanding sex‐specific factors contributing to advanced‐stage diagnosis can guide interventions to reduce sex inequality in patients with urological cancers.MethodWe used linked primary care and cancer registry data to examine associations between symptoms and advanced‐stage in 1151 bladder cancer and 440 renal cancer patients diagnosed between January 2012 and December 2015 in England. We performed logistic regression, adjusting for sex, age, deprivation and routes to diagnosis, including interaction terms between symptoms and sex and symptoms and age.ResultsFemale sex (OR vs. men 1.89 [1.28–2.79]; p = 0.001) and patients presenting with urinary tract infections (OR 2.22 [1.34–3.69]) and abdominal symptoms (OR 2.19 [1.30–3.70]) were associated with increased odds of advanced‐stage bladder cancer (vs. haematuria, p = 0.016 for both). Women with haematuria and men with abdominal symptoms (compared with the opposite sex with the same presenting symptom) were more likely to have advanced‐stage bladder cancer. Neither sex nor symptom associations were observed for renal cancer.ConclusionNon‐haematuria symptoms are associated with higher risk of advanced‐stage bladder cancer. Greater risk of advanced‐stage bladder cancer in women may reflect biological differences in haematuria onset and sex differences during diagnostic process. Identifying higher risk women with haematuria may reduce sex inequalities in bladder cancer outcomes.

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Abdominal investigations in the year preceding a diagnosis of abdominal cancer: A register-based cohort study in Denmark

Cited by 5 publications

References 35 publications

Does changing healthcare use signal opportunities for earlier detection of cancer? A review of studies using information from electronic patient records

Does changing healthcare use signal opportunities for earlier detection of cancer? A review of studies using information from electronic patient records

Healthcare use in the year preceding a diagnosis of pancreatic cancer: a register-based cohort study in Denmark

Understanding symptom contribution to sex inequality in bladder and renal cancer stage at diagnosis

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