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Decision support tools play role in identifying pancreatic cancer earlier

Posted by: Research 19 November 2014

The results of a study by a team at University College London (UCL) published today in BMJ Open, indicate that symptom-based cancer decision support tools are useful in identifying pancreatic ductal adenocarcinoma (PDAC) and biliary tract cancers (BTC) at an early stage. Also, by identifying clusters of unique symptoms in combination with results from routinely performed blood tests, GPs could make an earlier diagnosis of pancreatic cancer.

The study, which is the first to evaluate early symptoms of BTC in primary care, was supported by a Pancreatic Cancer UK grant as part of the charity’s commitment to fund projects that seek to improve the speed and accuracy of early diagnosis.

The study:

Pancreatic ductal adenocarcinoma (PDAC) is often diagnosed late and at an advanced stage which prevents effective treatment. Symptoms known to be indicative of pancreatic cancer include jaundice, unexplained weight loss abdominal pain and oily floating poo but currently diagnosis is only made if these symptoms are recognised by a medical professional.

The researchers at UCL, led by Dr Steve Pereira, used the Health Improvement Network (THIN) primary care database, which includes more than 11 million electronic patient records, from 562 GP practices in the UK to determine the early symptom profiles of PDAC.

The research also compared early symptom trends in patients with PDAC and biliary tract cancers (which are also diagnosed late) to define symptoms specific to PDAC, their timing of onset as well as markers of PDAC detected in the blood during routine testing nearest to the time of diagnosis.

Recently developed symptom-based cancer decision support tools are available to General Practitioner in the UK to help identify patients with suspected PDAC but further work is needed to refine these tools to improve their diagnostic accuracy.

Results:

Investigating nearly 3000 patient records (2773) the team identified that in the year prior to diagnosis, patients with PDAC visited their GP on a median of 18 occasions.

PDAC was associated with 11 alarm symptoms and BTC with 8. Back pain, lethargy and new onset diabetes were identified as unique features of PDAC.

Conclusions:

This work indicates that symptom-based cancer decision support tools are useful in identifying these PDAC (and BTCs) at an early stage and that by identifying clusters of unique symptoms in combination with results from routinely performed blood tests, GPs could make an earlier diagnosis of pancreatic cancer.

Now more needs to be done to link the profile of the actual tumour (when diagnosed) with these early symptoms.

We are pleased to announce that we have awarded Dr Steve Pereira and his team a further £379,722 for a three-year project looking at creating a rapid diagnostic pathway for patients with pancreatic cancer.