期刊
CANCER EPIDEMIOLOGY
卷 76, 期 -, 页码 -出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.canep.2021.102072
关键词
Early detection of cancer[MeSH Term]; Signs and symptoms[MeSH Term]; Healthcare use; Health records; Early diagnosis
资金
- Cancer Research UK Fellowship award [C18081/A18180]
- Cancer Research UK Population Research Catalyst Award [C8640/A23385]
- RREDD-HER project - International Alliance for Cancer Early Detection [C18081/A31373]
This review examined studies on pre-diagnostic changes in healthcare utilization among patients subsequently diagnosed with cancer. The findings show that changes in healthcare use can be observed at least six months before diagnosis for many common cancers, and even earlier for certain types of cancer like colorectal cancer, multiple myeloma, and brain tumors. Early changes were also identified for specific sites within the brain and colon. This suggests that improvements in diagnostic technologies or services could help shorten the diagnostic intervals for cancer detection.
Background: It has been proposed that changes in healthcare use before cancer diagnosis could signal opportunities for quicker detection, but systematic appreciation of such evidence is lacking. We reviewed studies examining pre-diagnostic changes in healthcare utilisation (e.g. rates of GP or hospital consultations, prescriptions or diagnostic tests) among patients subsequently diagnosed with cancer. Methods: We identified studies through Pubmed searches complemented by expert elicitation. We extracted information on the earliest time point when diagnosis could have been possible for at least some cancers, together with variation in the length of such 'diagnostic windows' by tumour and patient characteristics. Results: Across twenty-eight studies, changes in healthcare use were observable at least six months pre-diagnosis for many common cancers, and potentially even earlier for colorectal cancer, multiple myeloma and brain tumours. Early changes were also identified for brain and colon cancer sub-sites. Conclusion: Changing healthcare utilisation patterns before diagnosis indicate that future improvements in diagnostic technologies or services could help to shorten diagnostic intervals for cancer. There is greatest potential for quicker diagnosis for certain cancer types and patient groups, which can inform priorities for the development of decision support tools.
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