Publications by authors named "Ruth Swann"
Introduction: Use of investigations can help support the diagnostic process of patients with cancer in primary care, but the size of variation between patient group and between practices is unclear.
Methods: We analysed data on 53 252 patients from 1868 general practices included in the National Cancer Diagnosis Audit 2018 using a sequence of logistic regression models to quantify and explain practice-level variation in investigation use, accounting for patient-level case-mix and practice characteristics. Four types of investigations were considered: any investigation, blood tests, imaging and endoscopy.
Article Synopsis
- Prostate-Specific Antigen (PSA) testing is utilized in primary care to identify prostate cancer, and this study focuses on how many cases are diagnosed through asymptomatic PSA screenings.
- An analysis of data from the 2018 English National Cancer Diagnosis Audit revealed that 19% of prostate cancer cases were detected via asymptomatic PSA testing, with a significant portion (52.1%) being patients aged 50-69 years.
- Factors such as younger age, non-White ethnicity, lower deprivation, and fewer co-morbidities were linked to a higher likelihood of asymptomatic PSA diagnoses, highlighting considerable variability among different GP practices.
Article Synopsis
- About 19% of cancer patients are diagnosed after using emergency care, with varying pathways (Type-A: referrals and Type-B: admissions).
- Factors like co-morbidity, advanced cancer stage, and socio-economic status contribute to higher emergency diagnosis risk.
- Combining both emergency pathways (Type-A+B) shows stronger links to higher short-term mortality, highlighting the need for better diagnostic protocols.
Background: There is little evidence on variation in radiotherapy use in different countries, although it is a key treatment modality for some patients with cancer. Here we aimed to examine such variation.
Methods: This population-based study used data from Norway, the four UK nations (England, Northern Ireland, Scotland, and Wales), nine Canadian provinces (Alberta, British Columbia, Manitoba, New Brunswick, Newfoundland and Labrador, Nova Scotia, Ontario, Prince Edward Island, and Saskatchewan), and two Australian states (New South Wales and Victoria).
Background: There are few data on international variation in chemotherapy use, despite it being a key treatment type for some patients with cancer. Here, we aimed to examine the presence and size of such variation.
Methods: This population-based study used data from Norway, the four UK nations (England, Northern Ireland, Scotland, and Wales), eight Canadian provinces (Alberta, British Columbia, Manitoba, Newfoundland and Labrador, Nova Scotia, Ontario, Prince Edward Island, and Saskatchewan), and two Australian states (New South Wales and Victoria).
Background: Blood tests can support the diagnostic process in primary care. Understanding how symptomatic presentations are associated with blood test use in patients subsequently diagnosed with cancer can help to benchmark current practices and guide interventions.
Methods: English National Cancer Diagnosis Audit data on 39,751 patients with incident cancer in 2018 were analysed.
Background: Timely diagnosis of cancer in patients who present with symptoms in primary care is a quality-improvement priority.
Aim: To examine possible changes to aspects of the diagnostic process, and its timeliness, before and after publication of the National Institute for Health and Care Excellence's (2015) guidance on the referral of suspected cancer in primary care.
Design And Setting: Comparison of findings from population-based clinical audits of cancer diagnosis in general practices in England for patients diagnosed in 2018 or 2014.
Background: Blood tests can support the diagnostic process in patients with cancer but how often they are used is unclear.
Aim: To explore use of common blood tests before cancer diagnosis in primary care.
Design And Setting: English National Cancer Diagnosis Audit data on 39 752 patients with cancer diagnosed in 2018.
Background: Greater understanding of international cancer survival differences is needed. We aimed to identify predictors and consequences of cancer diagnosis through emergency presentation in different international jurisdictions in six high-income countries.
Methods: Using a federated analysis model, in this cross-sectional population-based study, we analysed cancer registration and linked hospital admissions data from 14 jurisdictions in six countries (Australia, Canada, Denmark, New Zealand, Norway, and the UK), including patients with primary diagnosis of invasive oesophageal, stomach, colon, rectal, liver, pancreatic, lung, or ovarian cancer during study periods from Jan 1, 2012, to Dec 31, 2017.
Background: There is uncertainty regarding how pre-existing conditions (morbidities) may influence the primary care investigation and management of individuals subsequently diagnosed with cancer.
Methods: We identified morbidities using information from both primary and secondary care records among 11,716 patients included in the English National Cancer Diagnosis Audit (NCDA) 2014. We examined variation in 5 measures of the diagnostic process (the primary care interval, diagnostic interval, number of pre-referral consultations, use of primary care-led investigations, and referral type) by both primary care- and hospital records-derived measures of morbidity.
Background: Pre-existing chronic conditions (morbidities) influence the diagnosis and management of cancer. The prevalence of specific morbidities in patients diagnosed with common and rarer cancers is inadequately described.
Methods: Using data from the English National Cancer Diagnosis Audit 2014, we studied 11 pre-existing morbidities recorded as yes/no items by participating general practitioners based on information included in primary care records.
Background: A recent meta-analysis of global research found cancer patients living in rural locations are 5% less likely to survive than their urban counterparts, a survival disadvantage that has never been satisfactorily explained.
Aims: [1] To describe and compare primary-care involvement in the diagnosis of cancer between rural and urban patients in Scotland. [2] To compare the length of key diagnostic pathway intervals between rural and urban cancer patients in Scotland.
Cancer diagnosis in Scottish primary care: Results from the National Cancer Diagnosis Audit.
Eur J Cancer Care (Engl)
May 2020
Objective: To characterize cancer diagnosis in Scottish primary care and draw comparisons with cancer diagnostic activity in England.
Method: A national audit of cancer diagnosis was conducted in Scottish and English general practices. Participating GPs collected diagnostic pathway data on patients diagnosed in 2014 from medical records.
Background: There is a growing emphasis on the speed of diagnosis as an aspect of cancer prognosis. While epidemiological data in the last decade have quantified diagnostic timeliness and its variation, whether and how often prolonged diagnostic intervals can be considered avoidable is unknown.
Methods: We used data from the English National Cancer Diagnosis Audit (NCDA) on 17,042 patients diagnosed with cancer in 2014.
Background: Early diagnosis interventions such as symptom awareness campaigns increasingly form part of global cancer control strategies. However, these strategies will have little impact in improving cancer outcomes if the targeted symptoms represent advanced stage of disease. Therefore, we aimed to examine associations between common presenting symptoms of cancer and stage at diagnosis.
View Article and Find Full Text PDFBackground: Continual improvements in diagnostic processes are needed to minimise the proportion of patients with cancer who experience diagnostic delays. Clinical audit is a means of achieving this.
Aim: To characterise key aspects of the diagnostic process for cancer and to generate baseline measures for future re-audit.
Background: A glycoproteomic study has previously shown cadherin-5 (CDH5) to be a serological marker of metastatic breast cancer when both protein levels and glycosylation status were assessed. In this study we aimed to further validate the utility of CDH5 as a biomarker for breast cancer progression.
Methods: A nested case-control study of serum samples from breast cancer patients, of which n=52 had developed a distant metastatic recurrence within 5 years post-diagnosis and n=60 had remained recurrence-free.
Background: Data for multiple common susceptibility alleles for breast cancer may be combined to identify women at different levels of breast cancer risk. Such stratification could guide preventive and screening strategies. However, empirical evidence for genetic risk stratification is lacking.
View Article and Find Full Text PDFArticle Synopsis
- * Research pooled data from over 6,000 ILC and LCIS cases and identified a specific SNP (rs11977670 at 7q34) that significantly predisposes to ILC.
- * The study highlights 56 polymorphisms associated with ILC and 15 with LCIS, showing that while many ER+ cancer loci relate to ILC, there are differences in susceptibility between ILC and ductal cancers (IDC).
Introduction: The distribution of histopathological features of invasive breast tumors in BRCA1 or BRCA2 germline mutation carriers differs from that of individuals with no known mutation. Histopathological features thus have utility for mutation prediction, including statistical modeling to assess pathogenicity of BRCA1 or BRCA2 variants of uncertain clinical significance. We analyzed large pathology datasets accrued by the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA) and the Breast Cancer Association Consortium (BCAC) to reassess histopathological predictors of BRCA1 and BRCA2 mutation status, and provide robust likelihood ratio (LR) estimates for statistical modeling.
View Article and Find Full Text PDFPurpose: The aim of the study was to investigate the vascular and stromal architecture of preclinical tumor models and patient tumor specimens from malignancies with known clinical outcomes to VEGFi treatment, to gain insight into potential determinants of intrinsic sensitivity and resistance.
Experimental Design: The tumor stroma architecture of preclinical and clinical tumor samples were analyzed by staining for CD31 and α-smooth muscle actin (α-SMA). Tumor models representative of each phenotype were then tested for sensitivity to the VEGFR2-blocking antibody DC101.
Article Synopsis
- - DietCompLyf is a study involving 3,159 women with grades I-III breast cancer across 56 UK hospitals, aiming to explore links between phytoestrogens (plant compounds with estrogen effects) and breast cancer recurrence and survival.
- - Participants provided detailed data on their health, diet, lifestyle, and quality of life for up to five years after diagnosis, with a focus on phytoestrogen intake assessed through a comprehensive food frequency questionnaire.
- - While certain patterns of phytoestrogen intake were noted (like younger patients consuming more isoflavones), no clear associations were found between their intake and better breast cancer prognosis, highlighting potential areas for further research.
The 19p13.1 breast cancer susceptibility locus is a modifier of breast cancer risk in BRCA1 mutation carriers and is also associated with the risk of ovarian cancer. Here, we investigated 19p13.
View Article and Find Full Text PDF