Examining methodology to identify patterns of consulting in primary care for different groups of patients before a diagnosis of cancer: a matched retrospective cohort study

Start Date Apr 2020

Code E18-C

Status Ongoing

Project Lead
Senior Lead
Dr Sarah Price, Prof Willie Hamilton (both Exeter), Prof Yoryos Lyratzopolous (UCL)

Project Summary

It can be difficult for family doctors to spot which of their patients need testing to find out if they have cancer, partly because so many cancer symptoms are vague. For patients with long-term medical conditions this is likely to be even harder, particularly if their conditions have the same symptoms as cancer. For example, people with chronic chest disease will often be short of breath and have a cough, which are also symptoms of lung cancer.

In this research, we will be developing new methods to find out if cancer diagnosis is significantly delayed in people with multiple health conditions. New methods are needed, because the ones we use now rely on identifying the first symptom of possible cancer.

We will study 3,000 people (cases) who have been diagnosed with cancer of the stomach or food gullet, and 3,000 people who do not have cancer (controls). Cases and controls will be paired on age, sex, their general practice, and their health burden. We will then divide our 6,000 patients into groups by their health burden. We are likely to have three groups: (1) a low health burden (no or only a few long-term conditions); (2) a medium health burden; and (3) a high health burden (many long-term health conditions).

We will work out everyone’s “normal” pattern for visiting the doctor in the two years before the case was diagnosed with cancer. From this, we will be able to work out when people start to visit their doctor more often than normal because of the undiagnosed cancer. We will develop a method for comparing this “pick-up” point in visits between the three groups, to test if it varies for patients with different health burdens.

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