The Society for Academic Primary Care’s regional annual conference was held this month, for clinicians and academics across the Southwest to share their latest activities and findings in primary care research.
The conference was hosted virtually by the University of Exeter across two days, with a huge variety of sessions held on topics including mental health, Covid, careers, chronic disease, prescribing, policymaking, infection and women’s health.
Cancer was a recurring topic throughout the conference, with a specific session about cancer held incorporating talks from national experts including members of the CanTest Collaborative. The CanTest team gave a snapshot of some of the projects they are working on, including:
Sarah Bailey (Senior Research Fellow) is currently researching prostate cancer (the 2nd biggest cause of cancer death in males). Her work involves the use of genetic risk scores (GRS), which gives each person a number predicting their risk of developing cancer by looking at their unique DNA make-up. By investigating this, Sarah hopes to explore the added value of utilising GRS in a primary care setting (i.e. when seeing your GP or ER doctor), which also ties in the NHS long-term plan of becoming the first health service to offer full genome sequencing at birth. It is hoped that by using GRS, those at risk of developing prostate cancer can be identified and treated earlier.
Tanimola Martins (Research Fellow) is investigating ethnic inequalities in the routes to diagnosis of various cancers. Typically, UK Asian and black ethnic groups have poorer outcomes and less positive experiences in primary care, so Tanimola is aiming to identify where ethnic inequalities lie in the diagnostic pathway (i.e., how people are diagnosed – e.g., via a GP, screening programme, emergency hospital visit etc.), with the goal of setting targeting interventions to overcome these. Findings currently suggest that whilst inequalities exist, the adverse cancer outcomes among ethnic minorities are unlikely to be solely from a poorer diagnostic process, and include other factors such as differences in access and attitudes to healthcare.
Bianca Weiring (Research Fellow) is studying how pre-existing medical conditions (also known as comorbidities when referring to more than one condition) may delay or contribute to the early diagnosis of cancer. Regular monitoring of patients with other conditions can help the early detection of cancer, however, an overlap in symptoms can complicate diagnosis and mask cancers. Competing demands i.e. the sole focus on a chronic condition can also hinder cancer diagnoses. Results show that those suffering with other conditions are more likely to receive an earlier cancer diagnosis, however, there is more work to be done around specific comorbidities (i.e. the combination of certain conditions and different types of cancers).
Melissa Barlow (PhD Student) talked through the subject of her PhD work so far, which focuses on lung cancer, the leading cause of cancer death in the world, and diagnoses for different ethnic groups. Lung cancer is most commonly diagnosed in the later stages, with survival rates dropping dramatically between stage 1 (57%) and stage 4 (3%). Thrombocytosis (a high platelet count, above a specific level) is a positive predictive marker for lung cancer and is often present before the onset of other symptoms. Melissa’s research aims to confirm a timeframe when platelet counts begin to rise before diagnosis, and if clinicians could consider lung cancer in patients with a steady rise in platelets even if this is below the standard threshold.
Liz Down (Graduate Research Assistant) is researching into the outcomes of blood tests for males in different ethnic groups in relation to prostate cancer diagnosis. Blood tests are often routinely taken in primary and secondary care scenarios, and Liz is assessing if abnormal test results vary across different ethnic groups, considering if GPs could use identical reference ranges for men of different ethnic groups, or if different ranges should be set to capture and flag abnormalities. Over 1.4M historical blood tests are being investigated, and any observed differences will form the basis for further research, with the aim of contributing to evidence-based guidance for clinicians on how best to interpret blood test results going forwards.
David Shotter (Graduate Research Assistant) is undertaking a project to determine alternative explanations for ‘features’ of cancer i.e. symptoms, signs or abnormal test results. There will often be a plausible explanation for a feature, such as a pre-existing chronic condition e.g. a cough which is a common symptom of both chronic obstructive pulmonary disease and lung cancer. In consultation with GPs, David captured common “alternative explanation” conditions for key features of cancer, and 395 pairs of cancer + other conditions were identified which could be used to identify patients whose diagnostic pathway may be affected by an alternative explanation for their cancer feature.
As well as the above cancer-session speakers, CanTest members also presented in and chaired further SAPC sessions, with huge appreciation going to Gary Abel (Chair of the Organising Committee), Richard Neal, Sarah Price, Willie Hamilton, Luke Mounce and Sam Merriel for their time and expertise. As research forges ahead, the team look forward to attending SAPC’s 50th annual scientific meeting in July this year at the University of Central Lancashire, where they hope to collaborate on the national themes of recovery and innovation.