Risk of uterine cancer in symptomatic women in primary care: case–control study using electronic records

Walker, Sarah; Hyde, Chris; Hamilton, William

doi:10.3399/bjgp13x671632

Cited by 49 publications

(41 citation statements)

References 21 publications

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“…Thrombocytosis is present in 1.5–2.2% of the primary care consulting population aged ≥40 years 4 – 6. A recent systematic review summarised the evidence from previous primary care studies 7.…”

Section: Introductionmentioning

confidence: 99%

Clinical relevance of thrombocytosis in primary care: a prospective cohort study of cancer incidence using English electronic medical records and cancer registry data

et al. 2017

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BackgroundThrombocytosis (raised platelet count) is an emerging risk marker of cancer, but the association has not been fully explored in a primary care context.AimTo examine the incidence of cancer in a cohort of patients with thrombocytosis, to determine how clinically useful this risk marker could be in predicting an underlying malignancy.Design and settingA prospective cohort study using Clinical Practice Research Datalink data from 2000 to 2013.MethodThe 1-year incidence of cancer was compared between two cohorts: 40 000 patients aged ≥40 years with a platelet count of >400 × 109/L (thrombocytosis) and 10 000 matched patients with a normal platelet count. Sub-analyses examined the risk with change in platelet count, sex, age, and different cancer sites.ResultsA total of 1098 out of 9435 males with thrombocytosis were diagnosed with cancer (11.6%; 95% confidence interval [CI] = 11.0 to 12.3), compared with 106 of 2599 males without thrombocytosis (4.1%; 95% CI = 3.4 to 4.9). A total of 1355 out of 21 826 females with thrombocytosis developed cancer (6.2%; 95% CI = 5.9 to 6.5), compared with 119 of 5370 females without (2.2%; 95% CI = 1.8 to 2.6). The risk of cancer increased to 18.1% (95% CI = 15.9 to 20.5) for males and 10.1% (95% CI = 9.0 to 11.3) for females, when a second raised platelet count was recorded within 6 months. Lung and colorectal cancer were more commonly diagnosed with thrombocytosis. One-third of patients with thrombocytosis and lung or colorectal cancer had no other symptoms indicative of malignancy.ConclusionThrombocytosis is a risk marker of cancer in adults; 11.6% and 6.2% cancer incidence in males and females, respectively, is worthy of further investigation for underlying malignancy. These figures well exceed the National Institute for Health and Care Excellence-mandated risk threshold of 3% risk to warrant referral for suspected cancer.

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Section: Introductionmentioning

confidence: 99%

Clinical relevance of thrombocytosis in primary care: a prospective cohort study of cancer incidence using English electronic medical records and cancer registry data

et al. 2017

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“…13,14 Non-parametric methods were used as the data were not normally distributed. Univariable analysis was performed on all features present in at least 2% of either cases or controls.…”

Section: Analysis and Statistical Methodsmentioning

confidence: 99%

“…13,14 The raised inflammatory markers variable included any of: abnormal erythrocyte sedimentation rate, plasma viscosity, or C-reactive protein. Abnormal liver function tests reflected a raised value of any of the hepatic enzymes.…”

Section: Composite Variablesmentioning

confidence: 99%

Quantifying the risk of Hodgkin lymphoma in symptomatic primary care patients aged ≥40 years: a case–control study using electronic records

et al. 2015

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Research Abstract BackgroundIn the UK, approximately five people are diagnosed with Hodgkin lymphoma (HL) daily. One-tenth of diagnoses are in those aged >75 years. AimTo establish a symptom profile of HL and quantify their risk in primary care patients aged ≥40 years. Design and settingMatched case-control study using Clinical Practice Research Datalink patient records. MethodPutative clinical features of HL were identified in the year before diagnosis. Results were analysed using conditional logistic regression and positive predictive values (PPVs) calculated for the consulting population. ResultsTwo-hundred and eighty-three patients aged ≥40 years, diagnosed with HL between 2000 and 2009, and 1237 age, sex, and general practice-matched participants were studied. Six features were independently associated with HL: lymphadenopathy (OR 280, 95% confidence interval [CI] = 25 to 3100), head and neck mass not described as lymphadenopathy (OR 260, 95% CI = 21 to 3200), other mass (OR 12, 95% CI = 4.4 to 35), thrombocytosis (OR 6.0, 95% CI = 2.6 to 14), raised inflammatory markers (OR 5.2, 95% CI = 3.0 to 9.0), and low full blood count (OR 2.8, 95% CI = 1.6 to 4.8). Lymphadenopathy per se has a positive predictive value (PPV) of 5.6% for HL in patients aged ≥60 years. ConclusionConsistent with secondary care findings, lymphadenopathy is the clinical feature with the highest risk of HL in primary care and warrants urgent investigation. Keywords diagnosis; Hodgkin lymphoma; primary health care.Quantifying the risk of Hodgkin lymphoma in symptomatic primary care patients aged ≥ 40 years: a case-control study using electronic records

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“…The methods follow that of previous papers by the same authors. [18][19][20] This large computerised database contains anonymised patient data from over 680 general practices, covering 8.8% of the UK population. Patient registration data and primary care clinical events are recorded.…”

Section: Methodsmentioning

confidence: 99%

Quantifying the risk of non-Hodgkin lymphoma in symptomatic primary care patients aged ≥40 years: a large case–control study using electronic records

et al. 2015

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Risk of uterine cancer in symptomatic women in primary care: case–control study using electronic records

Cited by 49 publications

References 21 publications

Clinical relevance of thrombocytosis in primary care: a prospective cohort study of cancer incidence using English electronic medical records and cancer registry data

Clinical relevance of thrombocytosis in primary care: a prospective cohort study of cancer incidence using English electronic medical records and cancer registry data

Quantifying the risk of Hodgkin lymphoma in symptomatic primary care patients aged ≥40 years: a case–control study using electronic records

Quantifying the risk of non-Hodgkin lymphoma in symptomatic primary care patients aged ≥40 years: a large case–control study using electronic records

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