Are there early symptoms of cancer that healthcare needs to be more observant of? And what early symptoms and combinations of symptoms occur in different cancers? These are two of the questions investigated in a large study in the Västra Götaland Region in Western Sweden.
Around 70 percent of all cancer is discovered by general practitioners, even if a final diagnosis is made at a hospital or specialist clinic. Despite this, knowledge of what early cancer symptoms patients go to primary care for is still inadequate.
By going one year back in time before the cancer diagnosis, the study will investigate what patients went to the doctor for in primary care, what symptoms the GP noted, what diagnosis was made and what examinations were done. This way, the combinations of symptoms will be studied, both alarming symptoms – meaning symptoms that may indicate a serious disease like cancer – and general, diffuse symptoms that occur in different cancers.
Much of our knowledge about cancers comes from the hospital world, but cancer symptoms change as the disease progresses.
“It is established knowledge that alarming symptoms for various cancers, such as skin changes that are slow to heal or blood in the feces or urine, have to lead to prompt investigation. But recent research shows that perhaps as much as half of the most common forms of cancer can present themselves through diffuse and general symptoms, such as fatigue and pain,” says Marcela Ewing, Medical Specialist in Internal Medicine and Oncology and the process owner at the Western Regional Cancer Center (Regionalt cancercentrum väst) that is leading the study.
Diffuse and general symptoms are, however, associated with many different diseases and can also be of a temporary nature.
“A GP can see several thousand patients a year, but on average, only a few in a thousand of them have cancer. This is why it is important to catch patients with suspected cancer early to be able to quickly begin an investigation,” says Marcela Ewing.
The first step in the study is to build up a database with data from the Central Cancer Registry, registries for lab tests and radiology, and the VEGA register, which is the Västra Götaland Region’s database for health care consumption. Based on this, the study will look at what symptoms or combinations of symptoms precede our six most common cancers. The ambition is to develop concrete tools for risk assessment based on the patient’s age, gender, symptoms and lab results. Such tools already exist for certain disease groups, including cardiovascular diseases.
In total, around 30,000 patients from the Västra Götaland Region are included in the study. Of them, 6,000 were diagnosed in 2011 with one of the six most common cancers, which were breast cancer, prostate cancer, colon cancer, lung cancer, gynecological cancer and skin cancer including malignant melanoma. The study runs to the end of 2018 and is a doctoral project at Sahlgrenska Academy at the University of Gothenburg in cooperation with the Western Regional Cancer Center.
By: KARIN ALLANDER
Western Regional Cancer Center
