Evidence map›Paper›PMID 32191753›Full record

ArticlePloS one2020

Diagnostic and health service pathways to diagnosis of cancer-registry notified cancer of unknown primary site (CUP).

Andrea L Schaffer, Sallie-Anne Pearson, Oscar Perez-Concha, Timothy Dobbins, Robyn L Ward, Marina T van Leeuwen, Joel J Rhee, Maarit A Laaksonen, Glynis Craigen, Claire M Vajdic

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.5field-weighted citation impact, top 34% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Andrea L SchafferCentre for Big Data Research in Health, UNSW Sydney, Sydney, Australia.ORCID 0000-0002-3701-4997
Sallie-Anne PearsonCentre for Big Data Research in Health, UNSW Sydney, Sydney, Australia.
Oscar Perez-ConchaCentre for Big Data Research in Health, UNSW Sydney, Sydney, Australia.
Timothy DobbinsNational Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.
Robyn L WardFaculty of Medicine and Health, University of Sydney, Sydney, Australia.
Marina T van LeeuwenCentre for Big Data Research in Health, UNSW Sydney, Sydney, Australia.
Joel J RheeCentre for Primary Health Care and Equity, UNSW Sydney, Sydney, Australia.
Maarit A LaaksonenCentre for Big Data Research in Health, UNSW Sydney, Sydney, Australia.
Glynis CraigenCancer Voices NSW, Sydney, Australia.
Claire M VajdicCentre for Big Data Research in Health, UNSW Sydney, Sydney, Australia.
UNSW Sydney · AUCancer Institute of New South Wales · AUThe University of Sydney · AUUniversity of Wollongong · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCancer of unknown primary (CUP) is a late-stage malignancy with poor prognosis, but we know little about what diagnostic tests and procedures people with CUP receive prior to diagnosis. The purpose of this study was to determine how health service utilisation prior to diagnosis for people with cancer-registry notified CUP differs from those notified with metastatic cancer of known primary.

methodsWe identified people with a cancer registry notification of CUP (n = 327) from the 45 and Up Study, a prospective cohort of 266,724 people ≥45 years in New South Wales, Australia, matched with up to three controls with a diagnosis of metastatic cancer of known primary (n = 977). Baseline questionnaire data were linked to population health data to identify all health service use, diagnostic tests, and procedures in the month of diagnosis and 3 months prior. We used conditional logistic regression to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs).

resultsAfter adjusting for age and educational attainment, people with a cancer-registry notified CUP diagnosis were more likely to be an aged care resident (OR = 2.78, 95%CI 1.37-5.63), have an emergency department visit (OR = 1.65, 95%CI 1.23-2.21), serum tumor marker tests (OR = 1.51, 95%CI 1.12-2.04), or a cytology test without immunohistochemistry (OR = 2.01, 95%CI 1.47-2.76), and less likely to have a histopathology test without immunohistochemistry (OR = 0.43, 95%CI 0.31-0.59). Neither general practitioner, specialist, allied health practitioner or nurse consultations, hospitalisations, nor imaging procedures were associated with a CUP diagnosis.

conclusionsThe health service and diagnostic pathway to diagnosis differs markedly for people notified with CUP compared to those with metastatic cancer of known primary. While these differences may indicate missed opportunities for earlier detection and appropriate management, for some patients they may be clinically appropriate.

Indexed as

Health ServicesRegistriesAgedAged, 80 and overFemaleHumansMaleMiddle AgedNeoplasm MetastasisNeoplasms, Unknown Primary

Identifiers

PMID32191753
PMCPMC7082007
OpenAlexW3010741085

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.