ArticleBMJ open2020
Cross-sectional study using primary care and cancer registration data to investigate patients with cancer presenting with non-specific symptoms.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05876676 (Rapid Diagnostic Centre Biomarker Study), which is not on this map. Cited by 28 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Rapid Diagnostic Centre Biomarker Study
Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The pathway and characteristics of patients with non-specific symptoms of cancer: a systematic review.BMC cancer · 2022Pooled it
- Implementation of a Quality Improvement and Clinical Decision Support Tool for Cancer Diagnosis in Primary Care: Process Evaluation.JMIR cancer · 2025Trial
- Performance of a Cell-Free DNA-Based Multi-cancer Detection Test in Individuals Presenting With Symptoms Suspicious for Cancers.JCO precision oncology · 2023Trial
- Randomised controlled trial and economic evaluation of a targeted cancer awareness intervention for adults living in deprived areas of the UK.British journal of cancer · 2021Trial
- Cancer risk in patients with four non-specific symptoms: a decade of research and implications for practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Blood test trend versus single threshold abnormality to discriminate cancer from non-cancer in patients with unexpected weight loss: A retrospective cohort study.PLoS medicine · 2026Article
- Later-Stage Diagnosis and Poorer Survival in Pancreatic Cancer Patients With Vague Symptoms: A Population-Based Study.United European gastroenterology journal · 2026Article
- Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors.Diagnostics (Basel, Switzerland) · 2026Review
- Missed opportunities for earlier cancer diagnosis within specific pathways to emergency presentation.Future oncology (London, England) · 2025Article
- Real-world data and clinical experience from over 100,000 multi-cancer early detection tests.Nature communications · 2025Article
- GP referral to rapid diagnostic centres for non-specific cancer symptoms: a qualitative study.BJGP open · 2025Article
- Doing 'detective work' to find a cancer: how are non-specific symptom pathways for cancer investigation organised, and what are the implications for safety and quality of care? A multisite qualitative approach.BMJ quality & safety · 2025Article
- Article
- A UK population-based case-control study of blood tests before cancer diagnosis in patients with non-specific abdominal symptoms.British journal of cancer · 2025Article
- Predictors of advanced-stage presentation among patients with a diagnosis of breast and cervical cancer in Ethiopia.The oncologist · 2025Article
- Exploring the policy implementation of a holistic approach to cancer investigation in non-specific symptom pathways in England: An ethnographic study.Journal of health services research & policy · 2025Article
- Article
- Diagnostic flow for all patients referred with non-specific symptoms of cancer to a diagnostic centre in Denmark: A descriptive study.The European journal of general practice · 2024Article
- Nonspecific Signs and/or Symptoms of Cancer: A Retrospective, Observational Analysis from a Secondary Care, US Community Oncology Dataset.Current oncology (Toronto, Ont.) · 2024Observational
- Transforming post pandemic cancer services.British journal of cancer · 2024Review
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
introductionPatients presenting to primary care with site-specific alarm symptoms can be referred onto urgent suspected cancer pathways, whereas those with non-specific symptoms currently have no dedicated referral routes leading to delays in cancer diagnosis and poorer outcomes. Pilot Multidisciplinary Diagnostic Centres (MDCs) provide a referral route for such patients in England.
objectivesThis work aimed to use linked primary care and cancer registration data to describe diagnostic pathways for patients similar to those being referred into MDCs and compare them to patients presenting with more specific symptoms.
methodsThis cross-sectional study linked primary care data from the National Cancer Diagnosis Audit (NCDA) to national cancer registration and Route to Diagnosis records. Patient symptoms recorded in the NCDA were used to allocate patients to one of two groups - those presenting with symptoms mirroring referral criteria of MDCs (non-specific but concerning symptoms (NSCS)) and those with at least one site-specific alarm symptom (non-NSCS). Descriptive analyses compared the two groups and regression analysis by group investigated associations with long primary care intervals (PCIs).
resultsPatients with NSCS were more likely to be diagnosed at later stage (32% stage 4, compared with 21% in non-NSCS) and via an emergency presentation (34% vs 16%). These patients also had more multiple pre-referral general practitioner consultations (59% vs 43%) and primary care-led diagnostics (blood tests: 57% vs 35%). Patients with NSCS had higher odds of having longer PCIs (adjusted OR: 1.24 (1.11 to 1.36)). Patients with lung and urological cancers also had higher odds of longer PCIs overall and in both groups.
conclusionsDifferences in the diagnostic pathway show that patients with symptoms mirroring the MDC referral criteria could benefit from a new referral pathway.
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