British Journal of Cancer

ObjectiveDiagnosing ovarian cancer in premenopausal women is challenging due to the rarity of cancer and the ubiquity of symptoms, ovarian cysts on ultrasound, and raised serum CA125 tumour marker levels. We investigated the accuracy of risk prediction models and scores for diagnosing ovarian cancer in premenopausal women presenting to secondary care with symptoms and abnormal tests. MethodsA cohort of premenopausal women presenting with non-specific symptoms, and raised CA125 or abnormal imagi...

ObjectiveAntihistamine use has previously been associated with a reduction in incidence of ovarian cancer, particularly in pre-menopausal women. Herein, we investigate antihistamine exposure in relation to ovarian cancer risk using a novel data resource by examining purchase histories from retailer loyalty card data. Study DesignA subset of participants from the Cancer Loyalty Card Study (CLOCS) for which purchase histories were available were analysed in this study. Cases (n=153) were women in...

IntroductionTechnological advances and direct-to-consumer marketing have unearthed significant organic demand from patients for cancer screening and prevention. However, in the absence of strong data or guidelines, physicians have minimal support on how to approach patients in clinical practice. MethodsWe projected individualized probabilities of 10-year and lifetime cancer risk across a population as well as potential improvement with healthy behaviors in the UK Biobank. ResultsA total of 118...

ObjectivesRobust evidence supports IOTA-ADNEX ultrasound triage at 10% threshold for ovarian cancer (OC) diagnosis to identify women for referral to tertiary gynaecological cancer centres for further management. The IOTA-ADNEX risk prediction model has superior sensitivity compared to the current standard of care triage, Risk of Malignancy Index (RMI-1), yet NHS adoption is limited. In our survey of British Gynaecological Cancer Society clinicians only 30% (24/79) currently follow an IOTA model,...

BackgroundAppendiceal tumors comprise a heterogeneous group of tumors which frequently disseminate to the peritoneum. Management of appendiceal tumors is lacking high quality data, given its rarity and heterogeneity. In general, appendiceal tumor treatment is extrapolated in part from colorectal cancer or pooled studies, without definitive evidence of disease-specific benefit. Many practices are controversial and vary widely between institutions. A national consensus update of best management pr...

PurposePancreatic cancer is a highly aggressive tumor, and early diagnosis and treatment significantly improves the clinical benefit for patients. However, currently there is a lack of effective methods to accurately detect this disease. In our study, we develop a liquid biopsy signature of EV miRNAs based on associated radiomics features of patients tumors in order to provide new insights for the early diagnosis of pancreatic cancer. Experimental DesignA total of eight datasets enrolled in thi...

BackgroundPDGRFA-mutant gastrointestinal tumours (GISTs) comprise approximately 10% of GISTs and are mostly gastric. Targeted therapies against these tumours have historically been limited by tyrosine kinase inhibitor (TKI)-resistance. We reviewed the characteristics and outcome of all PDGRFA-mutant patients seen at our centre over the last 13 years. MethodsAll PDGRFA-mutant patients seen at the Cambridge University Hospitals NHS Foundation Trust GIST clinic from July 2008-July 2021 were retros...

IntroductionColorectal cancer has low survival rates when diagnosed late-stage. We previously developed sex-specific dynamic risk prediction models utilising trends in the full blood count (FBC), a blood test commonly performed in primary care, to support early detection. We aimed to externally validate these prediction models. MethodsWe performed a hybrid case-control and cohort study of patients with at least one FBC test. We first excluded FBCs within two years before diagnosis (cases) or st...

ImportanceAppendiceal Adenocarcinoma is a rare tumor and given the inherent difficulties in performing prospective trials in such a rare disease currently there is a scant amount of high-quality data upon which to guide treatment decisions, which highlights the unmet need for more pre-clinical and clinical investigation for this orphan disease ObjectiveTo objectively evaluate the effectiveness of flouropyrimdine-based systemic chemotherapy in inoperable low-grade mucinous Appendiceal Adenocarci...

BackgroundThe recent staging manual upstages Node-negative tumor-deposit positive colorectal cancer (CRC) from N0 to N1c category, while the development of tumor-deposit presence is poorly understood. Meanwhile, Kras mutation is associated with progression of CRC, but its link to tumor-deposit status is unclear. MethodThis retrospective cohort study included the patients with incidental CRC diagnosed during 2010-2014 in the National Cancer Database and recorded statuses of Kras and tumor deposi...

BackgroundPancreatic cancer is the seventh leading cause of cancer-related mortality worldwide and the fifth in the United Kingdom (UK), with incidence rates nearly matching mortality. MethodsWe conducted a population-based cohort study using Clinical Practice Research Datalink (CPRD) GOLD and Aurum databases including patients aged 18+ with at least one year of prior data, diagnosed between 2000 and 2021. We estimated incidence, period prevalence, and survival at one, five, and ten years, stra...

BackgroundCystoscopy is a core component of haematuria investigations but is invasive and resource-intensive. GALEAS Bladder is a DNA-based diagnostic urine test that measures alterations in 23 bladder cancer-associated genes. ObjectiveTo assess the diagnostic performance and clinical utility of GALEAS Bladder as a molecular triage tool in real-world haematuria investigation pathways. MethodsPatients referred for urgent investigation of haematuria were prospectively enrolled across seven UK NH...

ObjectiveTo assess the costs and consequences of six diagnostic strategies for ovarian cancer in pre-menopausal and post-menopausal women with symptoms in secondary care. DesignEconomic evaluation alongside a prospective single-arm diagnostic accuracy study. SettingNHS secondary care outpatients (2-week referrals, clinics, GP referrals, cross-specialty referrals) and inpatients (emergency presentations to secondary care). SampleTwo cohorts of 857 pre-menopausal and 1,242 post-menopausal newly...

ImportanceSerum tumor markers CEA, CA19-9, & CA125 have been useful in the management of gastrointestinal and gynecological cancers, however there is limited information regarding their utility in patients with appendiceal adenocarcinoma. ObjectiveAssessing the association of serum tumor markers (CEA, CA19-9, and CA125) with clinical outcomes, pathologic, and molecular features in patients with appendiceal adenocarcinoma. DesignThis is a retrospective study with results reported in 2023. The m...

BackgroundAppendiceal tumors comprise a heterogeneous group of tumors which may be localized or disseminate throughout the peritoneum. Limited high quality clinical data exists and many practices have been extrapolated from colorectal cancer without validation in appendiceal cohorts. Many controversies exist regarding their treatment, and practices vary widely between centers and care settings. A national consensus update of best management practices for appendiceal malignancies was performed to...

ObjectivesThe detection of endometrial cancer recurrence is primarily through patient reported symptoms and can occur many years after primary treatment. Investigation of suspected endometrial cancer recurrence requires clinical examination, imaging, and if a lesion is identified a biopsy for pathological analysis. A blood-based biomarker could support the identification and confirmation of endometrial cancer recurrence. MethodsA systematic review was undertaken to identify studies that reporte...

Driver mutations in CTNNB1 are a hallmark of hepatoblastoma and offer a common biomarker for a liquid biopsy approach based on the presence of CTNNB1 circulating tumor DNA (ctDNA). We developed and investigated the utility of a quantitative universal next-generation sequencing (NGS) ctDNA assay for hepatoblastoma (QUENCH) to detect CTNNB1 ctDNA and assessed the links between ctDNA and current clinical indicators/biomarkers in hepatoblastoma. Applied to patients with hepatoblastoma, we demonstrat...

BackgroundNumerous studies have shown that elderly women with endometrial cancer (EC) have a higher risk of recurrence and cancer-related death. It is, however, unclear whether aging is a causal prognostic factor, or whether other risk factors become increasingly common with age. We address to this with a unique multi-method study design using state of the art statistical and causal inference techniques on datasets of three large randomised trials. MethodsData of 1801 women participating in the...

ObjectivesTo evaluate whether quantitative measurement of faecal haemoglobin (f-Hb) using faecal immunochemical testing (FIT) can be used to rule out colorectal cancer (CRC) for patients who present to primary care with high risk symptoms defined by national guidelines for urgent referral for suspected cancer (NICE NG12). DesignProspective cohort study carried out between April 2017 and March 2019. Setting59 GP practices in London and 24 hospitals in England. ParticipantsSymptomatic patients...

OBJECTIVETo provide insight into real-world surveillance practices for patients with low risk (LR), intermediate risk (IR), and (very) high risk (HR) non-muscle invasive bladder cancer (NMIBC). MATERIALS AND METHODSCystoscopy surveillance patterns were analysed using real-world data from two population-based cohort studies in the Netherlands, comparing practices to guideline recommendations by risk group. As bladder cancer-related symptoms may prompt diagnostic investigations beyond routine fol...