Suspected Cancer Symptoms and Blood Test Results in Primary Care Before a Diagnosis of Lung Cancer: A Case–Control Study

Abstract

Aim: To compare symptoms and blood test results prior to cancer diagnosis in individuals who developed lung cancer and those who did not. Patients&methods: Nested case–control study, lung cancer patients were matched to up four controls with no record of cancer. Differences in symptoms and blood test results were investigated in the 2-year period prior to diagnosis. Results: 26,379 lung cancer patients were matched to 92,125 controls. Elevated C-reactive protein (CRP) was independently predictive of lung cancer at every 2-month interval 12 months prior to diagnosis. Elevated CRP in conjunction with at least one symptom was associated with greater than fourfold higher odds of lung cancer. Conclusion: CRP may be a prediagnostic marker for lung cancer, and when present with other symptoms could facilitate the investigation of high-risk individuals.

Keywords::

• C-reactive protein
• CRP
• diagnosis
• lung cancer

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.tandfonline.com/doi/suppl/10.2217/fon-2019-0442

Author contributions

SV Ramagopalan is the guarantor of the study, conceived and designed it. A Harish led the analysis. All contributed to the analysis and interpretation of the data. SV Ramagopalan wrote the first draft and all contributed to subsequent drafts and the final paper.

Financial&competing interests disclosure

This study was funded by Bristol-Myers Squibb. L McDonald, R Carroll, N Tanna, F Mehmud and SV Ramagopalan are employees of Bristol-Myers Squibb. R Alikhan received financial support for this work from Bristol-Myers Squibb. A Harish is an employee of Mu Sigma. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

This study was approved by the Independent Scientific Advisory Committee (ISAC) with CPRD number 19_155.

Data sharing statement

CPRD data were provided under a license that does not permit sharing. Data are, however, obtainable directly from CPRD under their standard conditions.

Additional information

Funding

This study was funded by Bristol-Myers Squibb. L McDonald, R Carroll, N Tanna, F Mehmud and SV Ramagopalan are employees of Bristol-Myers Squibb. R Alikhan received financial support for this work from Bristol-Myers Squibb. A Harish is an employee of Mu Sigma. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.