| アブストラクト | Background: A platelet count >400 x 109/l (i.e. thrombocytosis) is a recently discovered risk marker of cancer. The risk of undiagnosed cancer in patients with thrombocytosis is 11.6% for men and 6.2% for women, well above the 3% risk threshold set by National Institute for Health and Care Excellence (NICE) for cancer investigation. Patients with a platelet count at the upper end of the normal range (325-400 x 109/l) could be at increased risk of undiagnosed malignancy. Objective: To quantify the risk of an undiagnosed cancer in patients with a platelet count at the upper end of the normal range. Methods: A primary care-based cohort study using Clinical Practice Research Datalink (CPRD) data from 2000 to 2013. The study sample comprised 2704 individuals stratified by platelet count: 325-349 x 109/l; 350-374 x 109/l; 375-399 x 109/l. Incident cancer diagnoses in the year following that platelet count were obtained from patient records. Results: Cancer incidence rose with increasing platelet count: 2.6% [95% confidence interval (CI) 1.9 to 3.6] in subjects with a count of 325-349 x 109/l, 3.7% (95% CI 2.5 to 5.3) in subjects with a count of 350-374 x 109/l and 5.1% (95% CI 3.4 to 7.5) in those with a count of 375-399 x 109/l. Colorectal cancer was most commonly diagnosed in all three groups. Cancer incidence was consistently higher in males than in females. Conclusion: These results suggest that clinicians should consider cancer in patients with a platelet count >375 x 109/l, review reasons for testing and any additional reported symptoms. Until these results are replicated on a larger scale, recommendations for clinical action cannot be made. |
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| ジャーナル名 | Family practice |
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| 投稿日 | 2018/4/17 |
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| 投稿者 | Ankus, Emily; Price, Sarah J; Ukoumunne, Obioha C; Hamilton, William; Bailey, Sarah E R |
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| 組織名 | University of South Florida, Tampa, Florida, USA.;Diagnosis of Symptomatic Cancer Optimally (DISCO).;National Institute for Health Research (NIHR) CLAHRC South West Peninsula,;University of Exeter Medical School, Exeter, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/29659802/ |
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