Changes in the presenting symptoms of lung cancer from 2000–2017: a serial cross-sectional study of observational records in UK primary care
Chowienczyk, S; Price, S; Hamilton, W
Date: 27 January 2020
Journal
British Journal of General Practice
Publisher
Royal College of General Practitioners
Publisher DOI
Abstract
Background
Most patients diagnosed with lung cancer present with symptoms. It is not known if the
proportions of patients with each presenting symptom has changed over time. Identifying
trends in lung cancer’s presenting symptoms is important for medical education and earlydiagnosis initiatives.
Aims
To identify the first reported ...
Background
Most patients diagnosed with lung cancer present with symptoms. It is not known if the
proportions of patients with each presenting symptom has changed over time. Identifying
trends in lung cancer’s presenting symptoms is important for medical education and earlydiagnosis initiatives.
Aims
To identify the first reported symptom of possible lung cancer (index symptom). To test
whether the percentages of patients with each index symptom changed during 2000–2017.
Design and Setting
This was a serial, cross-sectional, observational study using UK Clinical Practice Research
Datalink (CPRD) data with Cancer Registry linkage.
Methods
We identified the index symptom for patients with an incident diagnosis of lung cancer in
annual cohorts between 01/01/2000 and 31/12/2017. Searches were constrained to symptoms
in National Institute for Care Excellence suspected-cancer referral guidelines, and to the year
before diagnosis. We used generalised linear models (with a binomial function) to test if the
percentages of patients with each index symptom varied during 2000–2017.
Results
The percentage of patients with an index symptom of cough (odds ratio per year (OR) 1.01,
95% confidence interval (CI) 1.00-1.02 per year) or dyspnoea (1.05, 1.05-1.06 per year)
increased. The percentages of patients with other index symptoms decreased, notably
haemoptysis (0.93, 0.92-0.95) and appetite loss (0.94, 0.90-0.97) (all p<0.0001).
Conclusion
During 2000–2017, the proportions of lung cancer patients with an index symptom of cough
or dyspnoea increased, whilst haemoptysis decreased. This trend has implications for medical
education and symptom awareness campaigns.
Institute of Health Research
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This article is Open Access: CC BY 4.0 licence (https://creativecommons.org/licenses/by/4.0/).