| アブストラクト | Background Prescribing patterns in primary care could demonstrate early clinical features of cancer and windows of opportunity for timely investigation. Aim Analyse primary care prescription patterns prior to a pancreatic cancer diagnosis. Design and Setting Retrospective cohort study using linked primary care and cancer registry data from patients diagnosed with pancreatic cancer in England between 2011-2018. Method Prescription records registered in the Clinical Practice Research Datalink were analysed in the five years pre-diagnosis. Eight categories of prescriptions which may be used to treat clinical features of pancreatic cancer were included (anti-emetics, anti-reflux medications, insulin, other hypoglycaemic agents, opioids, non-opioid analgesics, neuropathic analgesics and non-steroidal anti-inflammatories). Poisson regression was used to estimate the inflection points for increased prescribing above baseline. Results Among 12,990 patients, 669,287 prescriptions were analysed. Insulin was the least common prescription (7% patients), anti-reflux the most common (53% patients). Insulin prescribing increased 19 months pre-diagnosis (95% confidence interval [CI]=14.2-23.8), rising earlier in females (25 months; 95% CI=17.4-32.5) than males (11 months; 95% CI=5.8-16.2). Prescriptions for other hypoglycaemic agents increased 13 months (95% CI=7.7-18.5), anti-reflux and opioid analgesic prescribing 7 months (95% CI=5.4-8.6 and 4.4-9.6, respectively) and anti-emetics and non-opioid analgesics 5 months (95% CI=2.9-7.1 and 3.2-6.8, respectively) prior to diagnosis. Conclusion The early increase in insulin prescribing suggests tumour-induced type 3c diabetes, highlighting an opportunity for earlier diagnosis in a small proportion of patients. Opportunities for earlier diagnosis through investigation and referral also exist in patients prescribed anti-emetic, anti-reflux, and analgesic medications in primary care. |
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| ジャーナル名 | The British journal of general practice : the journal of the Royal College of General Practitioners |
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| Pubmed追加日 | 2026/4/17 |
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| 投稿者 | Morel, Cecilia H; Walter, Fiona M; Virpal, Pawandeep; Arendse, Kirsten Deanne; Funston, Garth |
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| 組織名 | Queen Mary University of London, Barts Cancer Institute, London, United Kingdom.;Queen Mary University of London, Wolfson Institute of Population Health, London,;United Kingdom.;United Kingdom g.funston@qmul.ac.uk. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/41991223/ |
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