The Association between Blood Test Trends and Undiagnosed Cancer: A Systematic Review and Critical Appraisal

Author:

Virdee Pradeep S.1ORCID,Collins Kiana K.1ORCID,Friedemann Smith Claire1,Yang Xin2ORCID,Zhu Sufen1,Roberts Sophie E.3,Roberts Nia4ORCID,Oke Jason L.1,Bankhead Clare1ORCID,Perera Rafael1,Hobbs FD Richard1,Nicholson Brian D.1ORCID

Affiliation:

1. Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK

2. St Edmund Hall, University of Oxford, Oxford OX1 4AR, UK

3. Medical Sciences Division, St Peters College, University of Oxford, Oxford OX1 2DL, UK

4. Bodleian Health Care Libraries, Oxford OX3 7DQ, UK

Abstract

Clinical guidelines include monitoring blood test abnormalities to identify patients at increased risk of undiagnosed cancer. Noting blood test changes over time may improve cancer risk stratification by considering a patient’s individual baseline and important changes within the normal range. We aimed to review the published literature to understand the association between blood test trends and undiagnosed cancer. MEDLINE and EMBASE were searched until 15 May 2023 for studies assessing the association between blood test trends and undiagnosed cancer. We used descriptive summaries and narratively synthesised studies. We included 29 articles. Common blood tests were haemoglobin (24%, n = 7), C-reactive protein (17%, n = 5), and fasting blood glucose (17%, n = 5), and common cancers were pancreatic (29%, n = 8) and colorectal (17%, n = 5). Of the 30 blood tests studied, an increasing trend in eight (27%) was associated with eight cancer types, and a decreasing trend in 17 (57%) with 10 cancer types. No association was reported between trends in 11 (37%) tests and breast, bile duct, glioma, haematological combined, liver, prostate, or thyroid cancers. Our review highlights trends in blood tests that could facilitate the identification of individuals at increased risk of undiagnosed cancer. For most possible combinations of tests and cancers, there was limited or no evidence.

Funder

Cancer Research UK

Publisher

MDPI AG

Reference59 articles.

1. Cancer Research UK (2023, August 22). Cancer Statistics for the UK-Cancer Risk. Available online: https://www.cancerresearchuk.org/health-professional/cancer-statistics-for-the-uk#heading-Three.

2. Cancer Research UK (2023, August 22). Cancer Statistics for the UK-Cancer Screening and Diagnosis. Available online: https://www.cancerresearchuk.org/health-professional/cancer-statistics-for-the-uk#heading-Four.

3. Cancer Research UK (2023, August 22). Survival for Lung Cancer. Available online: https://www.cancerresearchuk.org/about-cancer/lung-cancer/survival.

4. Cancer Research UK (2023, August 22). Survival for Bowel Cancer. Available online: https://www.cancerresearchuk.org/about-cancer/bowel-cancer/survival.

5. Cancer Research UK (2023, August 22). Survival for Breast Cancer. Available online: https://www.cancerresearchuk.org/about-cancer/breast-cancer/survival.

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