Programme no. 335-OP
Diagnostic performance of blood tests in cancer diagnostics in patients with non-specific cancer symptoms.
Esben Næser*1, Ulrich Fredberg2, Peter Vedsted3, Henrik Møller4
1Research Centre for Cancer Diagnosis in Primary Care (CaP),The Research Unit for General Practice, Aarhus University.,Aarhus,Denmark, 2Diagnostic Centre, University Research Clinic for Innovative Patient Path,Silkeborg Regional Hospital,Silkeborg,Denmark, 3The Research Unit for General Practice and Research Centre for Cancer Diagnosis in Primary Care (CaP),Aarhus University,Aarhus,Denmark, 4Cancer Epidemiology and Population Health,King´s College London,London,Denmark
* = Presenting author
Objectives: The aim of the project is to analyze the diagnostic performance of blood tests used in cancer diagnostics in the NSSC-CPP.
Background: More than 25 % of cancer patients present with unspecific symptoms. Thus, the general practitioner (GP) often relies on further paraclinical testing when a cancer is suspected. In the Danish cancer patient pathway for patients with serious non-specific symptoms and signs of cancer (NSSC-CPP) a standardised set of blood tests are requested by the GP in all referred patients. Little is known about the diagnostic value of these blood test in patients with non-specific symptoms of cancer.
Results: 1552 patients were included in the study. 225 (12.4 %) patients were diagnosed with cancer within 6 months from the date of referral to NSSC-CPP. The detailed results will be available at the time of the conference.
Material/Methods: A prospective cohort study was performed including all patients referred from general practitioners to the NSSC-CPP during a 3-year period. Data were retrieved from the laboratory information system at the Silkeborg Regional Hospital, the Danish Cancer Registry and the National Patient Registry. The standardized blood test included inflammatory markers, hematological parameters, tumor markers and a comprehensive panel of metabolic tests. Contingency tables were used to calculate sensitivity, specificity and predictive values for individual blood tests in relation to the outcome of malignant disease. Receiver operation characteristic curves were constructed in order to examine cut-off levels for each specific paraclinical test result and the area under the curves were compared.
Conclusion: Knowledge of rational diagnostics in patients with non-specific cancer symptoms may lead to earlier diagnostics and optimization of the NSSC-CPP.
Points for discussion: The general value of the use of blood tests in cancer diagnostics will be discussed.