The impact of changing risk thresholds on the number of people in England eligible for urgent investigation for possible cancer: an observational cross-sectional study
dc.contributor.author | Moore, SF | |
dc.contributor.author | Price, SJ | |
dc.contributor.author | Chowienczyk, S | |
dc.contributor.author | Bostock, J | |
dc.contributor.author | Hamilton, W | |
dc.date.accessioned | 2021-09-22T10:08:05Z | |
dc.date.issued | 2021-09-16 | |
dc.description.abstract | Background: Expediting cancer diagnosis may be achieved by targeted decreases in referral thresholds to increase numbers of patients referred for urgent investigation. Methods: Clinical Practice Research Datalink data from England for 150,921 adults aged ≥40 were used to identify participants with features of possible cancer equating to risk thresholds ≥1%, ≥2% or ≥3% for breast, lung, colorectal, oesophago-gastric, pancreatic, renal, bladder, prostatic, ovarian, endometrial and laryngeal cancers. Results: The mean age of participants was 60 (SD 13) years, with 73,643 males (49%). In 2016, 8576 consultation records contained coded features having a positive predictive value (PPV) of ≥3% for any of the 11 cancers. This equates to a rate of 5682/100,000 patients compared with 4601/100,000 Suspected Cancer NHS referrals for these cancers from April 2016–March 2017. Nine thousands two hundred ninety-one patient-consultation records had coded features equating to a ≥2% PPV, 8% more than met PPV ≥ 3%. Similarly, 19,517 had features with a PPV ≥ 1%, 136% higher than for PPV ≥ 3%.< Conclusions: This study estimated the number of primary-care patients presenting at lower thresholds of cancer risk. The resource implications of liberalising this threshold to 2% are modest and manageable. The details across individual cancer sites should assist planning of English cancer services. | en_GB |
dc.description.sponsorship | National Institute for Health Research (NIHR) | en_GB |
dc.identifier.citation | Published online 16 September 2021 | en_GB |
dc.identifier.doi | 10.1038/s41416-021-01541-4 | |
dc.identifier.grantnumber | PR-PRU-1217-21601 | en_GB |
dc.identifier.grantnumber | ACF-2015-23-501 | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/127199 | |
dc.language.iso | en | en_GB |
dc.publisher | Springer Nature / Cancer Research UK | en_GB |
dc.rights | © The Author(s) 2021. Open Access. 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/. | en_GB |
dc.subject | Diagnosis | en_GB |
dc.subject | Epidemiology | en_GB |
dc.subject | Health policy | en_GB |
dc.title | The impact of changing risk thresholds on the number of people in England eligible for urgent investigation for possible cancer: an observational cross-sectional study | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2021-09-22T10:08:05Z | |
dc.identifier.issn | 0007-0920 | |
dc.description | This is the final version. Available on open access from Springer Nature via the DOI in this record. | en_GB |
dc.description | Data availability: The anonymised participant data from this study are not available, in line with the CPRD’s data security policy. CPRD code libraries are available from the authors on request. | en_GB |
dc.identifier.eissn | 1532-1827 | |
dc.identifier.journal | British Journal of Cancer | en_GB |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | en_GB |
dcterms.dateAccepted | 2021-08-24 | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2021-09-16 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2021-09-22T10:03:26Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2021-09-22T10:08:12Z | |
refterms.panel | A | en_GB |
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Except where otherwise noted, this item's licence is described as © The Author(s) 2021. Open Access. 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/.