Routine blood tests, typically ordered by doctors to investigate general health issues, may offer a much more significant role in the early diagnosis of cancer than previously realized.
According to a recent study, these tests, which are already widely available, could be instrumental in diagnosing cancer earlier, particularly for patients experiencing common gastrointestinal symptoms like stomach pain and bloating.
The study, led by researchers from University College London (UCL), revealed that abnormal results from 19 commonly used blood tests were associated with a higher likelihood of a cancer diagnosis within the following year. These findings suggest that, if carefully analyzed, blood test results could provide an additional layer of insight that helps to flag individuals who may be at risk for cancer, thus prompting earlier and potentially life-saving interventions.
The Significance of Stomach Pain and Bloating
Stomach pain and bloating are symptoms that affect a significant portion of the population and are frequently brought up during doctor visits. These symptoms, however, are not typically seen as direct indicators of cancer, which often leads to a delay in receiving an urgent cancer referral.
Current medical guidelines, including those from the UK’s National Institute for Health and Care Excellence (NICE), generally recommend that cancer referrals only be made when they are clear warning signs – known as “alarm symptoms” – such as unexplained weight loss or blood in the stool.
However, this study’s findings indicate that abnormal blood test results could help identify cancer risks in patients who do not exhibit these more obvious signs.
According to Dr. Meena Rafiq,, the lead author of the study, “Our study suggests we can improve cancer detection with blood tests that are already available and that are routinely given to patients with symptoms whose cause is unclear.”
“Given that in practice it may be challenging for GPs to interpret a range of blood test data, our study points to the need for an automated tool that could assess cancer risk based on multiple variables.”
A Closer Look at the Study
The research analyzed data from more than 450,000 adults in the UK who visited their general practitioners (GPs) with complaints of stomach pain or bloating. Out of this population, two-thirds underwent blood testing after their initial GP visit.
The data spanned a period from 2007 to 2016 and was anonymized through the Clinical Practice Research Datalink (CPRD), a database widely used in medical research.
The study found that abnormal results in specific blood tests were significantly linked to an increased risk of cancer. For example, common abnormalities included anemia, low albumin levels, high platelet counts, abnormal ferritin levels, and increased inflammatory markers.
These markers are not always regarded as indicators of cancer, but the study revealed that they could be strong predictors, especially when combined with other factors such as age and gender.
In fact, the study estimated that if doctors had taken abnormal blood test results into account when assessing patients, there would have been a 16% increase in the number of people with undiagnosed cancer who would have been urgently referred for further testing. This would amount to an additional six people per 1,000 who had visited their GP with stomach pain or bloating, on top of the 40 who would have already been referred based on symptoms alone.
Cancer Risk and Age
The study found that age was a crucial factor in assessing cancer risk. For instance, men in their 60s who visited their GP with stomach pain had a 3.1% chance of being diagnosed with cancer, and this risk rose to 8.6% for men in theirs 80s. For women, the risk was slightly lower but still significant, with a 3.1% cancer risk in theirs 60s and 6.1% in theirs 80s.
Interestingly, the research also showed that individuals aged 60 and over with stomach pain or bloating had a high enough cancer risk to warrant an urgent referral, regardless of blood test results. This is a key point, as current guidelines in the UK do not recommend cancer referrals for older adults unless they exhibit additional symptoms such as weight loss.
By integrating abnormal blood test results into the decision-making process, doctors could improve the early detection of cancer, particularly for older patients who may be at greater risk but do not present with the typical alarm symptoms.
The Role of Blood Tests in Predicting Cancer
The researchers discovered that several abnormal blood tests were strong predictors of undiagnosed cancer, especially in younger patients. For example, among women aged 50 to 59 who reported bloating, those with abnormal ferritin levels (a marker of iron storage in the body) had their cancer risk jump from 1.6% to 10%.
Similarly, raised platelet counts increased the risk to 8%, low albumin levels pushed it to 9%, and increased inflammatory markers raised the risk to 6%.
However, current cancer referral guidelines only include raised platelet counts and anemia as factors that may warrant further investigation. The study suggests that expanding the criteria to include other abnormal test results, such as low albumin or abnormal ferritin, could lead to earlier diagnoses and improved patient outcomes.
As Dr. Ragiq pointed out, “Half of all people with as-yet-undetected cancer will first go to the doctor with vague symptoms that can be challenging to diagnose.”
“Many of these patients are investigated in primary care with commonly used blood tests that could help to identify which patients are most likely to have underlying cancer and should be prioritized for referral.”
Types of Cancer Identified
The study also provided insights into the types of cancer that were most commonly diagnosed in people reporting stomach pain or bloating. In men, bowel cancer was the most frequently detected, followed by prostate and pancreatic cancers. Among women, bowel cancer was again the most common, followed by breast and ovarian cancers.
This information could prove invaluable for doctors assessing patients with vague symptoms. By understanding which cancers are more likely in individuals with certain blood test abnormalities, GPs could better prioritize their patients for urgent referral.
A Path Toward Better Cancer Diagnosis
One of the challenges highlighted by the study is the difficulty for GPs to interpret a wide range of blood test results, especially when the cause of a patient’s symptoms is unclear. To address this, Dr. Rafiq suggested that an automated tool could be develop to assess cancer risk based on multiple variables. Such a tool would help streamline the decision-making process and ensure that patients with a high risk of cancer are identified and referred as early as possible.
Ultimately, the study represents a significant step forward in the early detection of cancer. By utilizing routine blood test more effectively, doctors may be able to identify cancer risks sooner and provide life-saving treatment to more patients.
As Dr. Rafiq concluded, “This could be an efficient, affordable way to improve early cancer diagnosis and in some cases increase the likelihood of successful treatment.”
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