The Association between Blood Test Trends and Undiagnosed Cancer: A Systematic Review and Critical Appraisal

Abstract

Clinical guidelines include monitoring blood test abnormalities to identify patients at increased risk of undiagnosed cancer. Noting blood test changes over time may improve cancer risk stratification by considering a patient’s individual baseline and important changes within the normal range. We aimed to review the published literature to understand the association between blood test trends and undiagnosed cancer. MEDLINE and EMBASE were searched until 15 May 2023 for studies assessing the association between blood test trends and undiagnosed cancer. We used descriptive summaries and narratively synthesised studies. We included 29 articles. Common blood tests were haemoglobin (24%, n = 7), C-reactive protein (17%, n = 5), and fasting blood glucose (17%, n = 5), and common cancers were pancreatic (29%, n = 8) and colorectal (17%, n = 5). Of the 30 blood tests studied, an increasing trend in eight (27%) was associated with eight cancer types, and a decreasing trend in 17 (57%) with 10 cancer types. No association was reported between trends in 11 (37%) tests and breast, bile duct, glioma, haematological combined, liver, prostate, or thyroid cancers. Our review highlights trends in blood tests that could facilitate the identification of individuals at increased risk of undiagnosed cancer. For most possible combinations of tests and cancers, there was limited or no evidence.

Evaluation of silica spin‑column and magnetic bead formats for rapid DNA methylation analysis in clinical and point‑of‑care settings

“…Persistent infection by oncogenic human papillomavirus (HPV) is an etiological factor for cervical squamous cell carcinoma. HPV infection is associated with oncogenic progression of cervical intraepithelial neoplasia lesions Grades 1, 2, and 3 (CIN1-3) to carcinoma in situ and cervical cancer ( 5 ). However, more than 90% of HPV infections resolve without clinical consequence over several years ( 15 , 16 ), and ~30% of CIN3 progress to invasive cancer within 30 years of initial diagnosis ( 17 ).…”