| アブストラクト | BACKGROUND: Early 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. METHODS: Cohort 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. |
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| ジャーナル名 | British journal of cancer |
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| 投稿日 | 2019/4/25 |
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| 投稿者 | Watson, Jessica; Salisbury, Chris; Banks, Jonathan; Whiting, Penny; Hamilton, Willie |
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| 組織名 | Population Health Sciences, Bristol Medical School, University of Bristol,;Bristol, UK. jessica.watson@bristol.ac.uk.;NIHR CLAHRC West, Bristol, UK. jessica.watson@bristol.ac.uk.;Bristol, UK.;NIHR CLAHRC West, Bristol, UK.;University of Exeter Medical School, Bristol, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/31015558/ |
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