Journal article
Individual inflammatory marker abnormalities or inflammatory marker scores to identify primary care patients with unexpected weight loss for cancer investigation?
- Abstract:
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Background Combinations of inflammatory markers are used as prognostic scores in cancer patients with cachexia. We investigated whether they could also be used to prioritise patients attending primary care with unexpected weight loss for cancer investigation.
Methods We used English primary care electronic health records data linked to cancer registry data from 12,024 patients with coded unexpected weight loss. For each individual inflammatory marker and score we estimated the sensitivity, specificity, likelihood ratios, positive predictive value (PPV) and the area under the curve along with 95% confidence intervals for a cancer diagnosis within six months.
Results The risk of cancer associated with two abnormal inflammatory markers combined in a score was higher than the risk associated with individual inflammatory marker abnormalities. However, the risk of cancer in weight loss associated with individual abnormalities, notably a raised C-reactive protein, was sufficient to trigger further investigation for cancer under current NICE guidelines.
Conclusions If scores including pairs of inflammatory marker abnormalities were to be used, in preference to individual abnormalities, fewer people would be investigated to diagnose one cancer with fewer false positives, but fewer people with cancer would be diagnosed overall.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Version of record, 286.0KB, Terms of use)
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- Publisher copy:
- 10.1038/s41416-021-01282-4
Authors
- Grant:
- NF-SI-0617-10064
- CL-2019-13-005
- DRF-2015-08-185
- Publisher:
- Springer Nature
- Journal:
- British Journal of Cancer More from this journal
- Volume:
- 124
- Issue:
- 9
- Pages:
- 1540–1542
- Publication date:
- 2021-02-09
- Acceptance date:
- 2021-01-13
- DOI:
- EISSN:
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1532-1827
- ISSN:
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0007-0920
- Pmid:
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33558706
- Language:
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English
- Keywords:
- Pubs id:
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1161082
- Local pid:
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pubs:1161082
- Deposit date:
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2021-04-07
Terms of use
- Copyright holder:
- Nicholson et al.
- Copyright date:
- 2021
- Rights statement:
- © 2021 The Authors. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
- Licence:
- CC Attribution (CC BY)
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