{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T03:15:40Z","timestamp":1780629340185,"version":"3.54.1"},"reference-count":34,"publisher":"Royal College of General Practitioners","issue":"714","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Understanding pre-diagnostic test use could reveal diagnostic windows where more timely evaluation for cancer may be indicated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To examine pre-diagnostic patterns of results of abnormal blood tests in patients with bladder and renal cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>A retrospective cohort study using primary care and cancer registry data on patients with bladder and renal cancer who were diagnosed between April 2012 and December 2015 in England.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The rates of patients with a first abnormal result in the year before cancer diagnosis, for \u2018generic\u2019 (full blood count components, inflammatory markers, and calcium) and \u2018organ-specific\u2019 blood tests (creatinine and liver function test components) that may lead to subsequent detection of incidental cancers, were examined. Poisson regression was used to detect the month during which the cohort\u2019s rate of each abnormal test started to increase from baseline. The proportion of patients with a test found in the first half of the diagnostic window was examined, as these \u2018early\u2019 tests might represent opportunities where further evaluation could be initiated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data from 4533 patients with bladder and renal cancer were analysed. The monthly rate of patients with a first abnormal test increased towards the time of cancer diagnosis. Abnormalities of both generic (for example, high inflammatory markers) and organ-specific tests (for example, high creatinine) started to increase from 6\u20138 months pre-diagnosis, with 25%\u201340% of these patients having an abnormal test in the \u2018early half\u2019 of the diagnostic window.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Population-level signals of bladder and renal cancer can be observed in abnormalities in commonly performed primary care blood tests up to 8 months before diagnosis, indicating the potential for earlier diagnosis in some patients.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgp.2021.0282","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T12:26:53Z","timestamp":1634732813000},"page":"e19-e25","source":"Crossref","is-referenced-by-count":19,"title":["Identifying opportunities for timely diagnosis of bladder and renal cancer via abnormal blood tests: a longitudinal linked data study"],"prefix":"10.3399","volume":"72","author":[{"given":"Yin","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona M","family":"Walter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Mounce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary A","family":"Abel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hardeep","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willie","family":"Hamilton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant D","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Lyratzopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2021,10,20]]},"reference":[{"issue":"7","key":"2022011921351585000_72.714.e19.1","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1007\/s12325-019-00966-x","article-title":"Improving the timely detection of bladder and kidney cancer in primary care","volume":"36","author":"Zhou","year":"2019","journal-title":"Adv Ther"},{"key":"2022011921351585000_72.714.e19.2","unstructured":"National Institute for Health and Care Excellence (2021) Suspected cancer: recognition and referral NG12 (NICE, London) http:\/\/www.nice.org.uk\/guidance\/NG12 (accessed 24 Nov 2021)."},{"key":"2022011921351585000_72.714.e19.3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-029143"},{"issue":"4","key":"2022011921351585000_72.714.e19.4","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1002\/cncr.28416","article-title":"Sex disparities in diagnosis of bladder cancer after initial presentation with hematuria: a nationwide claims\u2013based investigation","volume":"120","author":"Cohn","year":"2014","journal-title":"Cancer"},{"key":"2022011921351585000_72.714.e19.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-002861"},{"key":"2022011921351585000_72.714.e19.6","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70041-4"},{"issue":"1","key":"2022011921351585000_72.714.e19.7","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1038\/bjc.2017.381","article-title":"Variation in \u2018fast-track\u2019 referrals for suspected cancer by patient characteristic and cancer diagnosis: evidence from 670 000 patients with cancers of 35 different sites","volume":"118","author":"Zhou","year":"2018","journal-title":"Br J Cancer"},{"key":"2022011921351585000_72.714.e19.8","doi-asserted-by":"crossref","unstructured":"Shephard E Neal R Rose P (2013) Clinical features of kidney cancer in primary care: a case-control study using primary care records. 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