ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2013
Risk of childhood cancer with symptoms in primary care: a population-based case-control study.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Cancer diagnostic tools to aid decision-making in primary care: mixed-methods systematic reviews and cost-effectiveness analysis.Health technology assessment (Winchester, England) · 2020Pooled it
- Is real world evidence influencing practice? A systematic review of CPRD research in NICE guidances.BMC health services research · 2016Pooled it
- Symptomatic diagnosis of cancer of the brain and central nervous system in primary care: a systematic review.Family practice · 2015Pooled it
- Socioeconomic differences in primary healthcare use before childhood cancer diagnosis: a register-based cohort study in Sweden.BMJ paediatrics open · 2026Article
- International variation in child healthcare practices and implications for childhood cancer diagnosis: a scoping review and cross-country clinician survey.European journal of pediatrics · 2026Article
- Use of healthcare services and prescription medication prior to sarcoma diagnosis in children, adolescents, and young adults in 1997-2020: a population-based cohort study.Cancer causes & control : CCC · 2025Article
- Quantifying diagnostic intervals and routes to diagnosis for children and young people with cancer in the UK (Childhood Cancer Diagnosis study, CCD): a population-based observational study.The Lancet regional health. Europe · 2025Article
- Malignant and Benign Head and Neck Tumors of the Pediatric Age: A Narrative Review.Current pediatric reviews · 2025Review
- Pediatric neck pain of a 10-year-old child with cervical spinal tumor evaluated and managed in direct access physical therapy: a case report.The Journal of manual & manipulative therapy · 2024Article
- Leukaemia diagnosis and primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- 'Never once was I thinking the c-word': Parent perspectives on the facilitators and barriers to getting a childhood cancer diagnosis.Journal of clinical nursing · 2023Article
- Underlying cancer risk among patients with fatigue and other vague symptoms: a population-based cohort study in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Article
- Clinical manifestations of head and neck cancer in pediatric patients, an analysis of 253 cases in a single Brazilian center.Medicina oral, patologia oral y cirugia bucal · 2022Article
- Helping GPs to diagnose children's cancer.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
- Parent's perspectives of the pathway to diagnosis of childhood cancer: a matter of diagnostic triage.BMC health services research · 2020Article
- Achieving a timely diagnosis for teenagers and young adults with cancer: the ACE "too young to get cancer?" study.BMC cancer · 2019Article
- Symptoms in primary care with time to diagnosis of brain tumours.Family practice · 2018Article
- Improving early diagnosis of symptomatic cancer.Nature reviews. Clinical oncology · 2016Review
- Article
- Data Resource Profile: Clinical Practice Research Datalink (CPRD).International journal of epidemiology · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGuidelines describing symptoms in children that should alert GPs to consider cancer have been developed, but without any supporting primary-care research.
aimTo identify symptoms and signs in primary care that strongly increase the likelihood of childhood cancer, to assist GPs in selection of children for investigation. DESIGN AND
settingA population-based case-control study in UK general practice.
methodUsing electronic primary care records from the UK General Practice Research Database, 1267 children aged 0-14 years diagnosed with childhood cancer were matched to 15 318 controls. Clinical features associated with subsequent diagnosis of cancer were identified using conditional logistic regression, and likelihood ratios and positive predictive values (PPVs) were estimated for each.
resultsTwelve symptoms were associated with PPVs of ≥0.04%, which represents a greater than tenfold increase in prior probability. The six symptoms with the highest PPVs were pallor (odds ratio, OR = 84; PPV = 0.41% (95% confidence interval [CI] = 0.12% to 1.34%), head and neck masses (OR = 17; PPV = 0.30%; 95% CI = 0.10% to 0.84%), masses elsewhere (OR = 22; PPV = 0.11%; 95% CI = 0.06% to 0.20%), lymphadenopathy (OR = 10; PPV = 0.09%; 95% CI = 0.06% to 0.13%), symptoms/signs of abnormal movement (OR = 16; PPV = 0.08%; 95% CI = 0.04% to 0.14%), and bruising (OR = 12; PPV = 0·08%; 95% CI = 0.05% to 0.13%). When each of these 12 symptoms was combined singly with at least three consultations in a 3-month period, the probability of cancer was between 11 and 76 in 10 000.
conclusionTwelve features of childhood cancers were identified, each of which increased the risk of cancer at least tenfold. These symptoms, particularly when combined with multiple consultations, warrant careful evaluation in general practice.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.