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Challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective UK cohort of patients presenting with suspected renal cancer

OBJECTIVES: To describe the frequency and nature of symptoms in patients presenting with suspected renal cell carcinoma (RCC) and examine their reliability in achieving early diagnosis. DESIGN: Multicentre prospective observational cohort study. SETTING AND PARTICIPANTS: Eleven UK centres recruiting...

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Autores principales: Vasudev, Naveen S, Wilson, Michelle, Stewart, Grant D, Adeyoju, Adebanji, Cartledge, Jon, Kimuli, Michael, Datta, Shibendra, Hanbury, Damian, Hrouda, David, Oades, Grenville, Patel, Poulam, Soomro, Naeem, Sullivan, Mark, Webster, Jeff, Selby, Peter J, Banks, Rosamonde E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223292/
https://www.ncbi.nlm.nih.gov/pubmed/32398335
http://dx.doi.org/10.1136/bmjopen-2019-035938
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author Vasudev, Naveen S
Wilson, Michelle
Stewart, Grant D
Adeyoju, Adebanji
Cartledge, Jon
Kimuli, Michael
Datta, Shibendra
Hanbury, Damian
Hrouda, David
Oades, Grenville
Patel, Poulam
Soomro, Naeem
Sullivan, Mark
Webster, Jeff
Selby, Peter J
Banks, Rosamonde E
author_facet Vasudev, Naveen S
Wilson, Michelle
Stewart, Grant D
Adeyoju, Adebanji
Cartledge, Jon
Kimuli, Michael
Datta, Shibendra
Hanbury, Damian
Hrouda, David
Oades, Grenville
Patel, Poulam
Soomro, Naeem
Sullivan, Mark
Webster, Jeff
Selby, Peter J
Banks, Rosamonde E
author_sort Vasudev, Naveen S
collection PubMed
description OBJECTIVES: To describe the frequency and nature of symptoms in patients presenting with suspected renal cell carcinoma (RCC) and examine their reliability in achieving early diagnosis. DESIGN: Multicentre prospective observational cohort study. SETTING AND PARTICIPANTS: Eleven UK centres recruiting patients presenting with suspected newly diagnosed RCC. Symptoms reported by patients were recorded and reviewed. Comprehensive clinico-pathological and outcome data were also collected. OUTCOMES: Type and frequency of reported symptoms, incidental diagnosis rate, metastasis-free survival and cancer-specific survival. RESULTS: Of 706 patients recruited between 2011 and 2014, 608 patients with a confirmed RCC formed the primary study population. The majority (60%) of patients were diagnosed incidentally. 87% of patients with stage Ia and 36% with stage III or IV disease presented incidentally. Visible haematuria was reported in 23% of patients and was commonly associated with advanced disease (49% had stage III or IV disease). Symptomatic presentation was associated with poorer outcomes, likely reflecting the presence of higher stage disease. Symptom patterns among the 54 patients subsequently found to have a benign renal mass were similar to those with a confirmed RCC. CONCLUSIONS: Raising public awareness of RCC-related symptoms as a strategy to improve early detection rates is limited by the fact that related symptoms are relatively uncommon and often associated with advanced disease. Greater attention must be paid to the feasibility of screening strategies and the identification of circulating diagnostic biomarkers.
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spelling pubmed-72232922020-05-15 Challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective UK cohort of patients presenting with suspected renal cancer Vasudev, Naveen S Wilson, Michelle Stewart, Grant D Adeyoju, Adebanji Cartledge, Jon Kimuli, Michael Datta, Shibendra Hanbury, Damian Hrouda, David Oades, Grenville Patel, Poulam Soomro, Naeem Sullivan, Mark Webster, Jeff Selby, Peter J Banks, Rosamonde E BMJ Open Oncology OBJECTIVES: To describe the frequency and nature of symptoms in patients presenting with suspected renal cell carcinoma (RCC) and examine their reliability in achieving early diagnosis. DESIGN: Multicentre prospective observational cohort study. SETTING AND PARTICIPANTS: Eleven UK centres recruiting patients presenting with suspected newly diagnosed RCC. Symptoms reported by patients were recorded and reviewed. Comprehensive clinico-pathological and outcome data were also collected. OUTCOMES: Type and frequency of reported symptoms, incidental diagnosis rate, metastasis-free survival and cancer-specific survival. RESULTS: Of 706 patients recruited between 2011 and 2014, 608 patients with a confirmed RCC formed the primary study population. The majority (60%) of patients were diagnosed incidentally. 87% of patients with stage Ia and 36% with stage III or IV disease presented incidentally. Visible haematuria was reported in 23% of patients and was commonly associated with advanced disease (49% had stage III or IV disease). Symptomatic presentation was associated with poorer outcomes, likely reflecting the presence of higher stage disease. Symptom patterns among the 54 patients subsequently found to have a benign renal mass were similar to those with a confirmed RCC. CONCLUSIONS: Raising public awareness of RCC-related symptoms as a strategy to improve early detection rates is limited by the fact that related symptoms are relatively uncommon and often associated with advanced disease. Greater attention must be paid to the feasibility of screening strategies and the identification of circulating diagnostic biomarkers. BMJ Publishing Group 2020-05-11 /pmc/articles/PMC7223292/ /pubmed/32398335 http://dx.doi.org/10.1136/bmjopen-2019-035938 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Oncology
Vasudev, Naveen S
Wilson, Michelle
Stewart, Grant D
Adeyoju, Adebanji
Cartledge, Jon
Kimuli, Michael
Datta, Shibendra
Hanbury, Damian
Hrouda, David
Oades, Grenville
Patel, Poulam
Soomro, Naeem
Sullivan, Mark
Webster, Jeff
Selby, Peter J
Banks, Rosamonde E
Challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective UK cohort of patients presenting with suspected renal cancer
title Challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective UK cohort of patients presenting with suspected renal cancer
title_full Challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective UK cohort of patients presenting with suspected renal cancer
title_fullStr Challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective UK cohort of patients presenting with suspected renal cancer
title_full_unstemmed Challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective UK cohort of patients presenting with suspected renal cancer
title_short Challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective UK cohort of patients presenting with suspected renal cancer
title_sort challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective uk cohort of patients presenting with suspected renal cancer
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223292/
https://www.ncbi.nlm.nih.gov/pubmed/32398335
http://dx.doi.org/10.1136/bmjopen-2019-035938
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