Table 1.
(a): Frequency of FBC, U&E, LFT, and IM blood tests based on presenting symptoms (proportions ranked by FBC order). (b): Frequency of bone profile, ferritin, serum protein, and amylase blood tests based on presenting symptoms (proportions ranked by FBC order).
| (a) | ||||||||
|---|---|---|---|---|---|---|---|---|
| Generic Blood Tests | ||||||||
| Symptom Name | FBC | % | U&E | % | LFT | % | IM | % |
| Fatigue (n = 1771) b | 1398 | 79 | 1267 | 72 | 1177 | 66 | 808 | 46 |
| Loss of appetite (n = 1264) a | 939 | 74 | 887 | 70 | 842 | 67 | 583 | 46 |
| Weight loss (n = 3408) c | 2331 | 68 | 2183 | 64 | 2090 | 61 | 1428 | 42 |
| Upper abdominal pain (n = 1192) b | 805 | 68 | 741 | 62 | 736 | 62 | 492 | 41 |
| Diarrhoea (n = 1013) b | 673 | 66 | 621 | 61 | 574 | 57 | 404 | 40 |
| Change in bowel habit (n = 1675) d | 1107 | 66 | 1013 | 60 | 941 | 56 | 633 | 38 |
| Nausea and/or vomiting (n = 1067) b | 693 | 65 | 666 | 62 | 648 | 61 | 433 | 41 |
| Abdominal pain (NOS) (n = 1932) c | 1233 | 64 | 1163 | 60 | 1114 | 58 | 736 | 38 |
| Lower abdominal pain (n = 1060) | 683 | 64 | 631 | 60 | 584 | 55 | 407 | 38 |
| Constipation (n = 831) b | 527 | 63 | 484 | 58 | 448 | 54 | 297 | 36 |
| Distension (n = 980) c | 609 | 62 | 593 | 61 | 539 | 55 | 352 | 36 |
| Back pain (n = 1405) a | 837 | 60 | 797 | 57 | 719 | 51 | 578 | 41 |
| Dyspepsia (n = 805) b | 468 | 58 | 436 | 54 | 414 | 51 | 247 | 31 |
| Rectal bleeding (n = 1662) e | 907 | 55 | 805 | 48 | 723 | 44 | 411 | 25 |
| Bone pain (n = 490) a | 262 | 53 | 249 | 51 | 222 | 45 | 185 | 38 |
| Other symptom (n = 2131) | 1093 | 51 | 1021 | 48 | 926 | 43 | 589 | 28 |
| Dyspnoea (n = 1751) b | 863 | 49 | 818 | 47 | 714 | 41 | 457 | 26 |
| Dysuria (n = 551) b | 255 | 46 | 263 | 48 | 199 | 36 | 110 | 20 |
| Urinary tract infection (n = 477) a | 209 | 44 | 217 | 45 | 148 | 31 | 93 | 19 |
| LUTS (nocturia, frequency, hesitancy, urgency, retention) (n = 4434) e | 1893 | 43 | 2139 | 48 | 1360 | 31 | 545 | 12 |
| Haematuria (n = 1465) d | 599 | 41 | 588 | 40 | 367 | 25 | 186 | 13 |
| Neck lump/mass (n = 1201) | 498 | 41 | 422 | 35 | 367 | 31 | 325 | 27 |
| Not applicable (n = 2795) | 1129 | 40 | 912 | 33 | 734 | 26 | 326 | 12 |
| Chest pain (n = 960) b | 387 | 40 | 365 | 38 | 330 | 34 | 236 | 25 |
| Not known (n = 687) | 270 | 39 | 219 | 32 | 200 | 29 | 76 | 11 |
| Dysphagia (n = 997) e | 383 | 39 | 366 | 37 | 341 | 35 | 190 | 19 |
| Cough (n = 2577) b | 982 | 38 | 944 | 37 | 807 | 31 | 620 | 24 |
| All other symptoms (n = 6828) | 2310 | 37 | 2115 | 34 | 1900 | 30 | 1316 | 21 |
| Chest infection (n = 686) a | 251 | 37 | 239 | 35 | 212 | 31 | 159 | 23 |
| Other vaginal bleeding (n = 421) | 131 | 31 | 91 | 22 | 74 | 18 | 37 | 9 |
| Haemoptysis (n = 469) e | 143 | 30 | 131 | 28 | 111 | 24 | 80 | 17 |
| Sore throat (n = 478) | 132 | 28 | 113 | 24 | 96 | 20 | 88 | 18 |
| Hoarseness (n = 468) c | 109 | 23 | 102 | 22 | 97 | 21 | 62 | 13 |
| Post-menopausal bleeding (n = 896) e | 166 | 19 | 145 | 16 | 124 | 14 | 61 | 7 |
| Breast pain (n = 768) b | 21 | 3 | 24 | 3 | 20 | 3 | 9 | 1 |
| Breast lump/mass (n = 4074) e | 102 | 3 | 109 | 3 | 80 | 2 | 44 | 1 |
| Abnormal mole (n = 1764) | 18 | 1 | 17 | 1 | 8 | 0 | 5 | 0 |
| All patients (n = 39,751) | 15,540 | 39 | 14,555 | 37 | 12,414 | 31 | 7598 | 19 |
| (b) | ||||||||
| Less Common Blood Tests | ||||||||
| Symptom Name | Bone Profile | % | Ferritin | % | Serum Protein Electrophoresis * | % | Amylase | % |
| Fatigue (n = 1771) b | 509 | 29 | 581 | 33 | 185 | 10 | 62 | 4 |
| Loss of appetite (n = 1264) a | 367 | 29 | 379 | 30 | 92 | 7 | 88 | 7 |
| Weight loss (n = 3408) c | 878 | 26 | 913 | 27 | 236 | 7 | 187 | 5 |
| Upper abdominal pain (n = 1192) b | 210 | 18 | 252 | 21 | 44 | 4 | 172 | 14 |
| Diarrhoea (n = 1013) b | 162 | 16 | 279 | 28 | 21 | 2 | 64 | 6 |
| Change in bowel habit (n = 1675) d | 287 | 17 | 483 | 29 | 35 | 2 | 75 | 4 |
| Nausea and/or vomiting (n = 1067) b | 229 | 21 | 238 | 22 | 37 | 3 | 97 | 9 |
| Abdominal pain (NOS) (n = 1932) c | 339 | 18 | 387 | 20 | 61 | 3 | 179 | 9 |
| Lower abdominal pain (n = 1060) | 195 | 18 | 233 | 22 | 23 | 2 | 39 | 4 |
| Constipation (n = 831) b | 185 | 22 | 204 | 25 | 34 | 4 | 39 | 5 |
| Distension (n = 980) c | 169 | 17 | 179 | 18 | 17 | 2 | 55 | 6 |
| Back pain (n = 1405) a | 425 | 30 | 207 | 15 | 251 | 18 | 37 | 3 |
| Dyspepsia (n = 805) b | 120 | 15 | 175 | 22 | 22 | 3 | 59 | 7 |
| Rectal bleeding (n = 1662) e | 175 | 11 | 411 | 25 | 18 | 1 | 24 | 1 |
| Bone pain (n = 490) a | 155 | 32 | 60 | 12 | 79 | 16 | 10 | 2 |
| Other symptom (n = 2131) | 368 | 17 | 368 | 17 | 136 | 6 | 56 | 3 |
| Dyspnoea (n = 1751) b | 243 | 14 | 254 | 15 | 44 | 3 | 14 | 1 |
| Dysuria (n = 551) b | 60 | 11 | 33 | 6 | 11 | 2 | 11 | 2 |
| Urinary tract infection (n = 477) a | 42 | 9 | 33 | 7 | 11 | 2 | 5 | 1 |
| LUTS ** (nocturia, frequency, hesitancy, urgency, retention) (n = 4434) e | 498 | 11 | 213 | 5 | 69 | 2 | 18 | <1% |
| Haematuria (n = 1465) d | 118 | 8 | 79 | 5 | 11 | 1 | 9 | 1 |
| Neck lump/mass (n = 1201) | 125 | 10 | 78 | 6 | 30 | 2 | 5 | <1% |
| Not applicable (n = 2795) | 259 | 9 | 334 | 12 | 151 | 5 | 20 | 1 |
| Chest pain (n = 960) b | 138 | 14 | 96 | 10 | 49 | 5 | 19 | 2 |
| Not known (n = 687) | 49 | 7 | 69 | 10 | 29 | 4 | 2 | <1% |
| Dysphagia (n = 997) e | 98 | 10 | 136 | 14 | 5 | 1 | 22 | 2 |
| Cough (n = 2577) b | 312 | 12 | 240 | 9 | 68 | 3 | 25 | 1 |
| All other symptoms *** (n = 6828) | 722 | 11 | 551 | 9 | 233 | 4 | 153 | 2 |
| Chest infection (n = 686) a | 74 | 11 | 48 | 7 | 15 | 2 | 8 | 1 |
| Other vaginal bleeding (n = 421) | 20 | 5 | 46 | 11 | 5 | 1 | 1 | <1% |
| Haemoptysis (n = 469) e | 38 | 8 | 29 | 6 | 3 | 1 | 3 | 1 |
| Sore throat (n = 478) | 27 | 6 | 28 | 6 | 6 | 1 | 3 | 1 |
| Hoarseness (n = 468) c | 26 | 6 | 30 | 6 | 5 | 1 | 2 | <1% |
| Post-menopausal bleeding (n = 896) e | 34 | 4 | 44 | 5 | 2 | <1% | 1 | <1% |
| Breast pain (n = 768) b | 4 | 1 | 7 | 1 | 3 | <1% | 0 | 0 |
| Breast lump/mass (n = 4074) e | 35 | 1 | 17 | <1% | 6 | <1% | 2 | <1% |
| Abnormal mole (n = 1764) | 4 | <1% | 4 | <1% | 0 | 0 | 0 | 0 |
| All patients (n = 39,752) | 4367 | 11 | 4299 | 11 | 1240 | 3 | 761 | 2 |
The blue–white–red boundaries are set at the upper, median, and lower values for each blood test. All other values are coloured proportionally. * Serum protein electrophoresis is coded as “Serum protein/paraprotein” in the NCDA. ** LUTS = lower urinary tract symptoms. *** Forty-six symptoms accounting for less than 1% (n = 398) of cases were grouped together, including nipple changes d, pelvic pain, lymphadenopathy (localised) a, jaundice e, night sweats, gastroesophageal reflux a, testicular lump, headache a, erectile dysfunction, prog/sub-acute loss of central neuro function, pruritis, lip/oral cavity/tongue lump/mass, testicular pain, loin pain, fever a, non-pigmented lesion e, axillary lump/mass, unexplained lump suspicious of sarcoma, lesions suspicious of BCC, nipple discharge e, thyroid lump/mass, lip/oral cavity/tongue ulcer, ulceration, early satiety, bruising, bleeding or petechiae, pallor, vaginal discharge b, anal mass, deep vein thrombosis a, visual disturbance or loss a, vulval mass, epistaxis, vulval ulceration, penile ulceration, vaginal mass, lymphadenopathy (generalised) a, fit/seizure b, new onset diabetes, stridor, leukoplakia a, fracture a, lymph node pain with alcohol, renal colic, clubbing, haematemesis c and vulval bleeding. a: denotes a PPV for cancer of 0.01–0.99%; b: denotes a PPV for cancer of 1.00–1.99%; c: denotes a PPV for cancer of 2.00–2.99%, d: denotes a PPV for cancer of 3.00–4.99%, e: denotes a PPV for cancer ≥5%, based on prior research [18] and clinicalguidelines [3] (for Supplementary Table S1).