Abstract | BACKGROUND: Over 15 000 new oesophago- gastric cancers are diagnosed annually in the United Kingdom, with most being advanced disease. We identified and quantified features of this cancer in primary care. METHODS: Case-control study using electronic primary-care records of the UK patients aged ≥40 years was performed. Cases with primary oesophago- gastric cancer were matched to controls on age, sex and practice. Putative features of cancer were identified in the year before diagnosis. Odds ratios ( ORs) were calculated for these features using conditional logistic regression, and positive predictive values (PPVs) were calculated. RESULTS: A total of 7471 cases and 32 877 controls were studied. Sixteen features were independently associated with oesophago- gastric cancer (all P<0.001): dysphagia, OR 139 (95% confidence interval 112-173); reflux, 5.7 (4.8-6.8); abdominal pain, 2.6 (2.3-3.0); epigastric pain, 8.8 (7.0-11.0); dyspepsia, 6 (5.1-7.1); nausea and/or vomiting, 4.9 (4.0-6.0); constipation, 1.5 (1.2-1.7); chest pain, 1.6 (1.4-1.9); weight loss, 8.9 (7.1-11.2); thrombocytosis, 2.4 (2.0-2.9); low haemoglobin, 2.4 (2.1-2.7); low MCV, 5.2 (4.2-6.4); high inflammatory markers, 1.7 (1.4-2.0); raised hepatic enzymes, 1.3 (1.2-1.5); high white cell count, 1.4 (1.2-1.7); and high cholesterol, 0.8 (0.7-0.8). The only PPV >5% in patients ≥55 years was for dysphagia. In patients <55 years, all PPVs were <1%. CONCLUSION: Symptoms of oesophago- gastric cancer reported in secondary care were also important in primary care. The results should inform guidance and commissioning policy for upper GI endoscopy.
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Authors | S Stapley, T J Peters, R D Neal, P W Rose, F M Walter, W Hamilton |
Journal | British journal of cancer
(Br J Cancer)
Vol. 108
Issue 1
Pg. 25-31
(Jan 15 2013)
ISSN: 1532-1827 [Electronic] England |
PMID | 23257895
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Abdominal Pain
- Adult
- Aged
- Aged, 80 and over
- Case-Control Studies
- Constipation
- Endoscopy, Digestive System
- Esophageal Neoplasms
(diagnosis)
- Female
- Humans
- Male
- Middle Aged
- Nausea
- Primary Health Care
- Risk
- Stomach Neoplasms
(diagnosis)
- Vomiting
- Weight Loss
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