Computer-based tool to improve diagnosis and prognosis for cancer patients

A computer-based tool could help GPs to speed up the diagnosis and treatment of patients suffering from two of the most common forms of cancer, potentially saving thousands of lives every year.

Researchers at The University of Nottingham and ClinRisk Ltd have shown that the algorithm is successful in identifying those suffering with gastro-oesophageal cancer and lung cancer at an earlier stage by 'red-flagging' potentially worrying combinations of symptoms and risk factors.

Their results, published in the British Journal of General Practice on Monday October 31, showed that the 10 per cent of the patients that the algorithm predicted as most at risk of developing one of the two diseases accounted for 77 per cent of all the gastro-oesophageal and lung cancers diagnosed over the following two years.

The research was led by Professor Julia Hippisley-Cox, in the University's Division of Primary Care. She said: "Earlier diagnosis of cancer is a major challenge and we hope this new research will help doctors identify patients for earlier referral and investigation."

The tool could help GPs to improve their record on early diagnosis in line with current Government policy and the National Awareness and Early Diagnosis Initiative (NAEDI) — a public sector/third sector partnership between the Department of Health, National Cancer Action Team, and Cancer Research UK. Evidence suggests that simply raising awareness of symptoms and speeding up diagnosis could save 5,000 lives a year without any new advances in medicine.

Two simple web calculators have been produced — one for lung cancer (www.qcancer/lung) and the other for gastro-oesophageal cancer (http://www.qcancer.org/gastro-oesophageal) — which are designed for use by doctors but a simpler version could also be made available on the internet to raise awareness among the general public and to prompt patients with high risk factors or symptoms to seek advice from their doctor.

Lung cancer is the most common cancer worldwide, with 1.3 million new cases diagnosed every year. It has one of the lowest survival rates because two-thirds of patients are diagnosed too late to be successfully treated.

It presents a huge challenge for family physicians because the symptoms can be common and non-specific. While smoking is a well-known risk factor, evidence suggests that other factors including age, social deprivation, and chronic obstructive airways disease also have an important part to play.

The presence of the disease can be indicated by 'red flag' symptoms such as new onset of coughing, coughing up blood (haemotypsis), weight loss, loss of appetite and anaemia. Currently, doctors focusing on just one of these symptoms without taking into account other risk factors are likely to miss 80 per cent of current lung cancer cases.

Similarly, gastro-oesophageal cancer is one of the most common cancers worldwide and earlier diagnosis could improve treatment options and improve five-year survival.