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Features of childhood cancer in primary care: a population-based nested case-control study

R M Dommett1, M T Redaniel, M C G Stevens

  • 1School of Clinical Sciences, University of Bristol, Level 6 UHB Education Centre, Upper Maudlin Street, Bristol BS2 8AE, UK.

British Journal of Cancer
|January 14, 2012
PubMed

Insights

Childhood cancer risk is linked to alert symptoms and frequent primary care visits. However, the positive predictive values for these indicators remain very low, meaning few children with these signs will actually have cancer.

Area of Science:

  • Pediatric Oncology
  • General Practice Research
  • Epidemiology

Background:

  • Investigating childhood cancer risk factors in primary care.
  • Focus on alert symptoms and consultation frequency.
  • Utilizing current UK guidance for symptom identification.

Purpose of the Study:

  • Assess the risk of childhood cancer.
  • Evaluate alert symptoms and increased consultation frequency.
  • Calculate likelihood ratios and positive predictive values (PPVs).

Main Methods:

  • Population-based, nested case-control study.
  • Data from the General Practice Research Database.
  • Matched 1267 childhood cancer cases (age 0-14) with 15,318 controls.

Main Results:

  • Alert symptoms were more common in cases (33.7% within 12 months, 27.0% within 3 months) vs. controls (5.4%, 1.4%).
  • Frequent consultations (≥4 in 3 months) were higher in cases (36%) than controls (9%).
  • Positive predictive values for cancer were low: 0.55/1000 for any alert symptom and 0.13/1000 for ≥4 consultations in 3 months.

Conclusions:

  • Alert symptoms and frequent consultations are associated with childhood cancer.
  • Individual symptoms and consultation patterns have very low positive predictive values for cancer in primary care.
  • Of 10,000 children with an alert symptom, only ~6 are diagnosed with cancer within 3 months.
Abstract

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