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A novel blood based triage test for colorectal cancer in primary care: a pilot study
BJGP Open, Volume: 7, Issue: 1, Start page: BJGPO.2022.0077
Swansea University Authors: Peter Dunstan , Dean Harris
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DOI (Published version): 10.3399/bjgpo.2022.0077
Abstract
Background: The majority of colorectal cancers (CRCs) are detected after symptomatic presentation to primary care. Given the shared symptoms of CRC and benign disorders, it is challenging to manage the risk of missed diagnosis. Colonoscopy resources cannot keep pace with increasing demand. There is...
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Royal College of General Practitioners
2023
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Given the shared symptoms of CRC and benign disorders, it is challenging to manage the risk of missed diagnosis. Colonoscopy resources cannot keep pace with increasing demand. There is a pressing need for access to simple triage tools in primary care to help prioritise patients for referral. Aim: To evaluate the performance of a novel spectroscopy-based CRC blood test in primary care. Design & setting: Mixed-methods pilot study of test performance and GP focus group discussions in South Wales. Method: Patients on the urgent suspected cancer (USC) pathway were recruited for the Raman spectroscopy (RS) test coupled to machine learning classification (‘Raman-CRC’) to identify CRC within the referred population. Qualitative focus group work evaluated the acceptability of the test in primary care by thematic analysis of focus group theorising. Results: A total of 532 patients aged ≥50 years referred on the USC pathway were recruited from 27 GP practices. Twenty-nine patients (5.0%) were diagnosed with CRC. Raman-CRC identified CRC with sensitivity 95.7%, specificity 69.3% with area under curve (AUC) of 0.80 compared with colonoscopy as the reference test (248 patients). Stage I and II cancers were detected with 78.6% sensitivity. Focus group themes underlined the convenience of a blood test for the patient and the test’s value as a risk assessment tool in primary care. Conclusion: The findings support this novel, non-invasive, blood-based method to prioritise those patients most likely to have CRC. Raman-CRC may accelerate access to diagnosis with potential to improve cancer outcomes.</abstract><type>Journal Article</type><journal>BJGP Open</journal><volume>7</volume><journalNumber>1</journalNumber><paginationStart>BJGPO.2022.0077</paginationStart><paginationEnd/><publisher>Royal College of General Practitioners</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2398-3795</issnElectronic><keywords>colorectal neoplasms, two-week waitpilot projects, qualitative research, Raman spectroscopy, primary health care, general practice</keywords><publishedDay>1</publishedDay><publishedMonth>3</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-03-01</publishedDate><doi>10.3399/bjgpo.2022.0077</doi><url>http://dx.doi.org/10.3399/bjgpo.2022.0077</url><notes/><college>COLLEGE NANME</college><department>Physics</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>SPH</DepartmentCode><institution>Swansea University</institution><apcterm/><funders/><projectreference/><lastEdited>2023-05-18T14:07:14.0128819</lastEdited><Created>2023-04-17T10:24:24.0778764</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Biosciences, Geography and Physics - Physics</level></path><authors><author><firstname>Cerys</firstname><surname>Jenkins</surname><order>1</order></author><author><firstname>Freya</firstname><surname>Woods</surname><order>2</order></author><author><firstname>Susan</firstname><surname>Chandler</surname><order>3</order></author><author><firstname>Kym</firstname><surname>Carter</surname><order>4</order></author><author><firstname>Rhys</firstname><surname>Jenkins</surname><order>5</order></author><author><firstname>Andrew</firstname><surname>Cunningham</surname><order>6</order></author><author><firstname>Kayleigh</firstname><surname>Nelson</surname><order>7</order></author><author><firstname>Rachel</firstname><surname>Still</surname><order>8</order></author><author><firstname>Jenna A</firstname><surname>Walters</surname><order>9</order></author><author><firstname>Non</firstname><surname>Gwynn</surname><order>10</order></author><author><firstname>Wilson</firstname><surname>Chea</surname><order>11</order></author><author><firstname>Rachel</firstname><surname>Harford</surname><order>12</order></author><author><firstname>Claire</firstname><surname>O'Neill</surname><order>13</order></author><author><firstname>Julie</firstname><surname>Hepburn</surname><order>14</order></author><author><firstname>Ian</firstname><surname>Hill</surname><order>15</order></author><author><firstname>Heather</firstname><surname>Wilkes</surname><order>16</order></author><author><firstname>Greg</firstname><surname>Fegan</surname><order>17</order></author><author><firstname>Peter</firstname><surname>Dunstan</surname><orcid>0000-0002-4337-4307</orcid><order>18</order></author><author><firstname>Dean</firstname><surname>Harris</surname><orcid>0000-0003-2673-8946</orcid><order>19</order></author></authors><documents><document><filename>63168__27063__c4bca163f21940669f0e52dd0d1b169c.pdf</filename><originalFilename>63168.pdf</originalFilename><uploaded>2023-04-17T10:28:51.6612135</uploaded><type>Output</type><contentLength>1065436</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807> |
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v2 63168 2023-04-17 A novel blood based triage test for colorectal cancer in primary care: a pilot study eada15d4d33fcb3dfddcff43f1323bd6 0000-0002-4337-4307 Peter Dunstan Peter Dunstan true false 731533890c5123febe4f65dffd369f7b 0000-0003-2673-8946 Dean Harris Dean Harris true false 2023-04-17 SPH Background: The majority of colorectal cancers (CRCs) are detected after symptomatic presentation to primary care. Given the shared symptoms of CRC and benign disorders, it is challenging to manage the risk of missed diagnosis. Colonoscopy resources cannot keep pace with increasing demand. There is a pressing need for access to simple triage tools in primary care to help prioritise patients for referral. Aim: To evaluate the performance of a novel spectroscopy-based CRC blood test in primary care. Design & setting: Mixed-methods pilot study of test performance and GP focus group discussions in South Wales. Method: Patients on the urgent suspected cancer (USC) pathway were recruited for the Raman spectroscopy (RS) test coupled to machine learning classification (‘Raman-CRC’) to identify CRC within the referred population. Qualitative focus group work evaluated the acceptability of the test in primary care by thematic analysis of focus group theorising. Results: A total of 532 patients aged ≥50 years referred on the USC pathway were recruited from 27 GP practices. Twenty-nine patients (5.0%) were diagnosed with CRC. Raman-CRC identified CRC with sensitivity 95.7%, specificity 69.3% with area under curve (AUC) of 0.80 compared with colonoscopy as the reference test (248 patients). Stage I and II cancers were detected with 78.6% sensitivity. Focus group themes underlined the convenience of a blood test for the patient and the test’s value as a risk assessment tool in primary care. Conclusion: The findings support this novel, non-invasive, blood-based method to prioritise those patients most likely to have CRC. Raman-CRC may accelerate access to diagnosis with potential to improve cancer outcomes. Journal Article BJGP Open 7 1 BJGPO.2022.0077 Royal College of General Practitioners 2398-3795 colorectal neoplasms, two-week waitpilot projects, qualitative research, Raman spectroscopy, primary health care, general practice 1 3 2023 2023-03-01 10.3399/bjgpo.2022.0077 http://dx.doi.org/10.3399/bjgpo.2022.0077 COLLEGE NANME Physics COLLEGE CODE SPH Swansea University 2023-05-18T14:07:14.0128819 2023-04-17T10:24:24.0778764 Faculty of Science and Engineering School of Biosciences, Geography and Physics - Physics Cerys Jenkins 1 Freya Woods 2 Susan Chandler 3 Kym Carter 4 Rhys Jenkins 5 Andrew Cunningham 6 Kayleigh Nelson 7 Rachel Still 8 Jenna A Walters 9 Non Gwynn 10 Wilson Chea 11 Rachel Harford 12 Claire O'Neill 13 Julie Hepburn 14 Ian Hill 15 Heather Wilkes 16 Greg Fegan 17 Peter Dunstan 0000-0002-4337-4307 18 Dean Harris 0000-0003-2673-8946 19 63168__27063__c4bca163f21940669f0e52dd0d1b169c.pdf 63168.pdf 2023-04-17T10:28:51.6612135 Output 1065436 application/pdf Version of Record true This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/) true eng http://creativecommons.org/licenses/by/4.0/ |
title |
A novel blood based triage test for colorectal cancer in primary care: a pilot study |
spellingShingle |
A novel blood based triage test for colorectal cancer in primary care: a pilot study Peter Dunstan Dean Harris |
title_short |
A novel blood based triage test for colorectal cancer in primary care: a pilot study |
title_full |
A novel blood based triage test for colorectal cancer in primary care: a pilot study |
title_fullStr |
A novel blood based triage test for colorectal cancer in primary care: a pilot study |
title_full_unstemmed |
A novel blood based triage test for colorectal cancer in primary care: a pilot study |
title_sort |
A novel blood based triage test for colorectal cancer in primary care: a pilot study |
author_id_str_mv |
eada15d4d33fcb3dfddcff43f1323bd6 731533890c5123febe4f65dffd369f7b |
author_id_fullname_str_mv |
eada15d4d33fcb3dfddcff43f1323bd6_***_Peter Dunstan 731533890c5123febe4f65dffd369f7b_***_Dean Harris |
author |
Peter Dunstan Dean Harris |
author2 |
Cerys Jenkins Freya Woods Susan Chandler Kym Carter Rhys Jenkins Andrew Cunningham Kayleigh Nelson Rachel Still Jenna A Walters Non Gwynn Wilson Chea Rachel Harford Claire O'Neill Julie Hepburn Ian Hill Heather Wilkes Greg Fegan Peter Dunstan Dean Harris |
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BJGP Open |
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BJGPO.2022.0077 |
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2023 |
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Swansea University |
issn |
2398-3795 |
doi_str_mv |
10.3399/bjgpo.2022.0077 |
publisher |
Royal College of General Practitioners |
college_str |
Faculty of Science and Engineering |
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Faculty of Science and Engineering |
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School of Biosciences, Geography and Physics - Physics{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Biosciences, Geography and Physics - Physics |
url |
http://dx.doi.org/10.3399/bjgpo.2022.0077 |
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active_str |
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description |
Background: The majority of colorectal cancers (CRCs) are detected after symptomatic presentation to primary care. Given the shared symptoms of CRC and benign disorders, it is challenging to manage the risk of missed diagnosis. Colonoscopy resources cannot keep pace with increasing demand. There is a pressing need for access to simple triage tools in primary care to help prioritise patients for referral. Aim: To evaluate the performance of a novel spectroscopy-based CRC blood test in primary care. Design & setting: Mixed-methods pilot study of test performance and GP focus group discussions in South Wales. Method: Patients on the urgent suspected cancer (USC) pathway were recruited for the Raman spectroscopy (RS) test coupled to machine learning classification (‘Raman-CRC’) to identify CRC within the referred population. Qualitative focus group work evaluated the acceptability of the test in primary care by thematic analysis of focus group theorising. Results: A total of 532 patients aged ≥50 years referred on the USC pathway were recruited from 27 GP practices. Twenty-nine patients (5.0%) were diagnosed with CRC. Raman-CRC identified CRC with sensitivity 95.7%, specificity 69.3% with area under curve (AUC) of 0.80 compared with colonoscopy as the reference test (248 patients). Stage I and II cancers were detected with 78.6% sensitivity. Focus group themes underlined the convenience of a blood test for the patient and the test’s value as a risk assessment tool in primary care. Conclusion: The findings support this novel, non-invasive, blood-based method to prioritise those patients most likely to have CRC. Raman-CRC may accelerate access to diagnosis with potential to improve cancer outcomes. |
published_date |
2023-03-01T14:07:12Z |
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11.035349 |