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Algorithms were applied to the electronic medical record, and used demographic information and abnormal test results that are associated with a risk of undiagnosed cancer (that is, anaemia\/iron deficiency, thrombocytosis, and raised prostate-specific antigen) to identify patients requiring further investigation and provide recommendations for care. The intervention consisted of the FHT cancer module, a case-based learning series, and ongoing practice support. Using the intention-to-treat approach, the between-arm difference in the proportion of patients with abnormal test results who were followed up according to guidelines was determined at 12 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 7555 patients were identified as at risk of undiagnosed cancer. At 12 months post-randomisation, 76.0% of patients in the intervention arm had received recommended follow-up (21 practices,<jats:italic>n<\/jats:italic>= 2820\/3709), compared with 70.0% in the control arm (19 practices,<jats:italic>n<\/jats:italic>= 2693\/3846; estimated between-arm difference = 2.6% [95% confidence interval (CI)] = \u22122.8% to 7.9%; odds ratio = 1.15 [95% CI = 0.87 to 1.53];<jats:italic>P<\/jats:italic>= 0.332).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The FHT cancer module intervention did not increase the proportion of patients receiving guideline-concordant care. The proportion of patients receiving recommended follow-up was high, suggesting a possible ceiling effect for the intervention.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgp.2024.0491","type":"journal-article","created":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T12:35:13Z","timestamp":1732106113000},"page":"e306-e315","source":"Crossref","is-referenced-by-count":4,"title":["Future Health Today and patients at risk of undiagnosed cancer: a pragmatic cluster randomised trial of quality-\u200aimprovement activities in general practice"],"prefix":"10.3399","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1746-5851","authenticated-orcid":false,"given":"Sophie","family":"Chima","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2493-9974","authenticated-orcid":false,"given":"Javiera","family":"Martinez-Gutierrez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1268-3166","authenticated-orcid":false,"given":"Barbara","family":"Hunter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3545-4785","authenticated-orcid":false,"given":"Adrian","family":"Laughlin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0393-8734","authenticated-orcid":false,"given":"Patty","family":"Chondros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7471-2487","authenticated-orcid":false,"given":"Natalie","family":"Lumsden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4779-7083","authenticated-orcid":false,"given":"Douglas","family":"Boyle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3548-4167","authenticated-orcid":false,"given":"Craig","family":"Nelson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3507-2982","authenticated-orcid":false,"given":"Paul","family":"Amores","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0224-2858","authenticated-orcid":false,"given":"An","family":"Tran-Duy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2153-3482","authenticated-orcid":false,"given":"Jo-Anne","family":"Manski-Nankervis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5274-6336","authenticated-orcid":false,"given":"Jon","family":"Emery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2024,11,20]]},"reference":[{"key":"2025050203501007000_75.754.e306.1","doi-asserted-by":"crossref","unstructured":"Swann R McPhail S Witt J (2018) Diagnosing cancer in primary care: results from the National Cancer Diagnosis Audit. 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