{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T22:26:12Z","timestamp":1788560772321,"version":"build-2803163510"},"reference-count":39,"publisher":"Royal College of General Practitioners","issue":"721","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":[[2022,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Proinflammatory conditions are associated with increased risk of Hodgkin lymphoma, although the neoplastic process <jats:italic>per se<\/jats:italic> often induces an inflammatory response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To examine pre-diagnostic inflammatory marker test use to identify changes that may define a \u2018diagnostic window\u2019 for potential earlier diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>This was a matched case\u2013control study in UK primary care using Clinical Practice Research Datalink data (2002\u20132016).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Primary care inflammatory marker test use and related findings were analysed in 839 Hodgkin lymphoma patients and 5035 controls in the year pre-diagnosis. Poisson regression models were used to calculate monthly testing rates to examine changes over time in test use. Longitudinal trends in test results and the presence\/absence of \u2018red-flag\u2019 symptoms were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In patients with Hodgkin lymphoma, 70.8% (594\/839) had an inflammatory marker test in the year pre-diagnosis versus 16.2% (816\/5035) of controls (odds ratio 13.7, 95% CI = 11.4 to 16.5, <jats:italic>P<\/jats:italic>&lt;0.001). The rate of inflammatory marker testing and mean levels of certain inflammatory marker results increased progressively during the year pre-diagnosis in Hodgkin lymphoma patients while remaining stable in controls. Among patients with Hodgkin lymphoma with a pre-diagnostic test, two-thirds (69.5%, 413\/594) had an abnormal result and, among these, 42.6% (176\/413) had no other \u2018red-flag\u2019 presenting symptom\/sign.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Increases in inflammatory marker requests and abnormal results occur in many patients with Hodgkin lymphoma several months pre-diagnosis, suggesting this period should be excluded in aetiological studies examining inflammation in Hodgkin lymphoma development, and that a diagnostic time window of appreciable length exists in many patients with Hodgkin lymphoma, many of whom have no other red-flag features.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgp.2021.0617","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T17:24:06Z","timestamp":1649697846000},"page":"e546-e555","source":"Crossref","is-referenced-by-count":9,"title":["Inflammatory marker testing in primary care in the year before Hodgkin lymphoma diagnosis: a UK population-based case\u2013control study in patients aged \u226450 years"],"prefix":"10.3399","volume":"72","author":[{"given":"Meena","family":"Rafiq","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Abel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Renzi","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":[[2022,4,7]]},"reference":[{"key":"2022072817254212000_72.721.e546.1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2013.191"},{"issue":"1","key":"2022072817254212000_72.721.e546.2","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/2052-1839-13-9","article-title":"Time-to-diagnosis and symptoms of myeloma, lymphomas and leukaemias: a report from the Haematological Malignancy Research Network","volume":"13","author":"Howell","year":"2013","journal-title":"BMC Blood Disord"},{"key":"2022072817254212000_72.721.e546.3","doi-asserted-by":"crossref","unstructured":"Lamb MJ Roman E Howell DA (2019) Hodgkin lymphoma detection and survival: findings from the Haematological Malignancy Research Network. 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