Quantifying the impact of pre-existing conditions on the stage of oesophagogastric cancer at diagnosis: a primary care cohort study using electronic medical records
dc.contributor.author | Quiroga, M | |
dc.contributor.author | Shephard, EA | |
dc.contributor.author | Mounce, LTA | |
dc.contributor.author | Carney, M | |
dc.contributor.author | Hamilton, WT | |
dc.contributor.author | Price, SJ | |
dc.date.accessioned | 2021-01-04T07:24:07Z | |
dc.date.issued | 2020-12-21 | |
dc.description.abstract | Background Pre-existing conditions interfere with cancer diagnosis by offering diagnostic alternatives, competing for clinical attention or through patient surveillance. Objective To investigate associations between oesophagogastric cancer stage and pre-existing conditions. Methods Retrospective cohort study using Clinical Practice Research Datalink (CPRD) data, with English cancer registry linkage. Participants aged ≥40 years had consulted primary care in the year before their incident diagnosis of oesophagogastric cancer in 01/01/2010–31/12/2015. CPRD records pre-diagnosis were searched for codes denoting clinical features of oesophagogastric cancer and for pre-existing conditions, including those providing plausible diagnostic alternatives for those features. Logistic regression analysed associations between stage and multimorbidity (≥2 conditions; reference category: no multimorbidity) and having ‘diagnostic alternative(s)’, controlling for age, sex, deprivation and cancer site. Results Of 2444 participants provided, 695 (28%) were excluded for missing stage, leaving 1749 for analysis (1265/1749, 72.3% had advanced-stage disease). Multimorbidity was associated with stage [odds ratio 0.63, 95% confidence interval (CI) 0.47–0.85, P = 0.002], with moderate evidence of an interaction term with sex (1.76, 1.08–2.86, P = 0.024). There was no association between alternative explanations and stage (odds ratio 1.18, 95% CI 0.87–1.60, P = 0.278). Conclusions In men, multimorbidity is associated with a reduced chance of advanced-stage oesophagogastric cancer, to levels seen collectively for women. | en_GB |
dc.description.sponsorship | USF Health Morsani College of Medicine, Research, Innovation & Scholarly Endeavors | en_GB |
dc.description.sponsorship | National Institute for Health Research (NIHR) | en_GB |
dc.description.sponsorship | Cancer Research UK | en_GB |
dc.identifier.citation | Published online 21 December 2020 | en_GB |
dc.identifier.doi | 10.1093/fampra/cmaa132 | |
dc.identifier.grantnumber | C8640/A23385 | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/124270 | |
dc.language.iso | en | en_GB |
dc.publisher | Oxford University Press (OUP) | en_GB |
dc.rights | © The Author(s) 2020. Published by Oxford University Press. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. | en_GB |
dc.subject | Cancer care/oncology | en_GB |
dc.subject | cancer epidemiology | en_GB |
dc.subject | doctor–patient relationship | en_GB |
dc.subject | electronic medical records | en_GB |
dc.subject | medical comorbidity | en_GB |
dc.subject | primary care | en_GB |
dc.title | Quantifying the impact of pre-existing conditions on the stage of oesophagogastric cancer at diagnosis: a primary care cohort study using electronic medical records | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2021-01-04T07:24:07Z | |
dc.description | This is the final version. Available on open access from Oxford University Press via the DOI in this record | en_GB |
dc.description | Data availability: The anonymized patient data from this study are not available due to legal privacy restrictions enforced by the CPRD. Code lists and symptom libraries are available from the authors by request. | en_GB |
dc.identifier.eissn | 1460-2229 | |
dc.identifier.journal | Family Practice | en_GB |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | en_GB |
exeter.funder | ::Cancer Research UK | en_GB |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2020-12-21 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2020-12-28T10:00:51Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2021-01-04T07:24:10Z | |
refterms.panel | A | en_GB |
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.