| アブストラクト | Early diagnosis of cancer relies on accurate assessment of cancer risk in patients presenting with symptoms, when screening is not appropriate. But recorded symptoms in cancer patients pre-diagnosis may vary between different sources of electronic health records (EHRs), either genuinely or due to differential completeness of symptom recording. To assess possible differences, we analysed primary care EHRs in the year pre-diagnosis of cancer in UK Biobank and Clinical Practice Research Datalink (CPRD) populations linked to cancer registry data. We developed harmonised phenotypes in Read v2 and CTV3 coding systems for 21 symptoms and eight blood tests relevant to cancer diagnosis. Among 22,601 CPRD and 11,594 UK Biobank cancer patients, 54% and 36%, respectively, had at least one consultation for possible cancer symptoms recorded in the year before their diagnosis. Adjusted comparisons between datasets were made using multivariable Poisson models, comparing rates of symptoms/tests in CPRD against expected rates if cancer site-age-sex-deprivation associations were the same as in UK Biobank. UK Biobank cancer patients compared with those in CPRD had lower rates of consultation for possible cancer symptoms [RR: 0.61 (0.59-0.63)], and lower rates for any primary care consultation [RR: 0.86 (95%CI 0.85-0.87)]. Differences were larger for 'non-alarm' symptoms [RR: 0.54 (0.52-0.56)], and smaller for 'alarm' symptoms [RR: 0.80 (0.76-0.84)] and blood tests [RR: 0.93 (0.90-0.95)]. In the CPRD cohort, approximately representative of the UK population, half of cancer patients had recorded symptoms in the year before diagnosis. The frequency of non-specific presenting symptoms recorded in the year pre-diagnosis of cancer was substantially lower among UK Biobank participants. The degree to which results based on highly selected biobank cohorts are generalisable needs to be examined in disease-specific contexts. |
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| ジャーナル名 | PLOS digital health |
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| Pubmed追加日 | 2023/12/15 |
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| 投稿者 | Barclay, Matthew; Renzi, Cristina; Antoniou, Antonis; Denaxas, Spiros; Harrison, Hannah; Ip, Samantha; Pashayan, Nora; Torralbo, Ana; Usher-Smith, Juliet; Wood, Angela; Lyratzopoulos, Georgios |
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| 組織名 | Department of Behavioural Science and Health, Institute of Epidemiology and;Healthcare, University College London, London, United Kingdom.;Faculty of Medicine, University Vita-Salute San Raffaele, Milan, Italy.;Department of Public Health and Primary Care, School of Clinical Medicine,;University of Cambridge, Cambridge, United Kingdom.;Institute of Health Informatics, University College London, London, United;Kingdom.;Victor Phillip Dahdaleh Heart and Lung Research Institute, University of;Cambridge, Cambridge, United Kingdom.;Department of Applied Health Research, Institute of Epidemiology and Healthcare,;University College London, London, United Kingdom.;British Heart Foundation Centre of Research Excellence, University of Cambridge,;Cambridge, United Kingdom.;National Institute for Health and Care Research Blood and Transplant Research;Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, United;Health Data Research UK Cambridge, Wellcome Genome Campus and University of;Cambridge Centre for Artificial Intelligence in Medicine, University of |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/38100737/ |
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