Rocky Mountain Cancer Centers, Englewood, CO 80113, USA.
Ontada, Boston, MA 02109, USA.
Curr Oncol. 2024 Jun 25;31(7):3643-3656. doi: 10.3390/curroncol31070268.
To help determine the unmet need for improved diagnostic tools to evaluate patients with nonspecific signs and/or symptoms (NSSS) and suspicion of cancer, we examined patient characteristics, diagnostic journey, and cancer incidence of patients with NSSS within The US Oncology Network (The Network), a secondary care community oncology setting. This retrospective, observational cohort study included patients aged ≥40 years with ≥1 NSSS in their problem list at their first visit within The Network (the index date) between 1 January 2016 and 31 December 2020. Patients were followed longitudinally with electronic health record data for initial cancer diagnosis, new noncancer diagnosis, death, end of study observation period, or 12 months, whichever occurred first. Of 103,984 patients eligible for inclusion, 96,722 presented with only 1 NSSS at index date; 6537/103,984 (6.3%) were diagnosed with 1 primary cancer within 12 months after the index date; 3825/6537 (58.5%) with hematologic malignancy, and 2712/6537 (41.5%) with solid tumor. Among patients diagnosed with cancer (n = 6774), the median time to cancer diagnosis after their first visit within The Network was 5.13 weeks. This study provides a real-world perspective on cancer incidence in patients with NSSS referred to a secondary care setting and highlights the unmet need for improved diagnostic tools to improve cancer outcomes.
为了帮助确定是否需要改进诊断工具来评估具有非特异性症状和/或体征(NSSS)且怀疑患有癌症的患者,我们检查了在美国肿瘤网络(The Network)中具有 NSSS 的患者的患者特征、诊断过程和癌症发病率。The Network 是一个二级保健社区肿瘤学环境。这项回顾性观察性队列研究纳入了 2016 年 1 月 1 日至 2020 年 12 月 31 日期间首次在 The Network 就诊时其问题清单上至少有 1 个 NSSS 的年龄≥40 岁的患者。使用电子健康记录数据对患者进行纵向随访,以确定初始癌症诊断、新的非癌症诊断、死亡、研究观察期结束或 12 个月(以先发生者为准)。在符合纳入条件的 103984 例患者中,有 96722 例患者在就诊日期仅存在 1 个 NSSS;有 6537/103984(6.3%)例患者在就诊日期后 12 个月内被诊断为 1 种原发性癌症;有 3825/6537(58.5%)例为血液系统恶性肿瘤,有 2712/6537(41.5%)例为实体瘤。在诊断为癌症的患者(n=6774)中,从首次就诊到诊断出癌症的中位数时间为 5.13 周。本研究从真实世界的角度提供了在二级保健环境中就诊的具有 NSSS 的患者的癌症发病率的信息,并强调了需要改进诊断工具来改善癌症结局。