期刊
BRITISH JOURNAL OF CANCER
卷 101, 期 -, 页码 S80-S86出版社
NATURE PUBLISHING GROUP
DOI: 10.1038/sj.bjc.6605396
关键词
diagnosis; primary health care; predictive values
类别
资金
- Department of Health
- NHS Research General Practices Scheme (brain)
- Bobby Moore Fund of Cancer Research UK (anaemia)
- NIHR
- Royal College of General Practitioners/BUPA awards
- Walport Fellowship
BACKGROUND: This paper reviews the background to five primary care case-control studies, collectively known as the CAPER studies (Cancer Prediction in Exeter). These studies, on colorectal, lung, prostate and brain tumours, sought to identify the particular features of cancer as reported to primary care. They also sought to quantify the risk of cancer for symptoms and primary care investigations, both individually and paired together. METHODS: Two studies were on colorectal cancer: the former with 349 cases used hand searching and coding of entries, while the latter obtained 6442 cases from a national electronic database. The lung and prostate studies had 247 and 217 cases, respectively, and used manual methods. The brain study also used a national electronic database, which provided 3505 cases. RESULTS: Generally, the symptoms matched previous series from secondary care, though the risks of cancer, expressed as positive predictive values, were lower. Rectal bleeding in colorectal cancer, and haemoptysis in lung cancer both had positive predictive values of 2.4%. The risk of a brain tumour with headache was one in a thousand. INTERPRETATION: The results identify areas where current guidance on urgent referral for investigation of suspected cancer could be improved. British Journal of Cancer (2009) 101, S80-S86. doi: 10.1038/sj.bjc.6605396 www.bjcancer.com (C) 2009 Cancer Research UK
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