Table 1. Details of the different outcome measures considered.
| Outcome | Measurement | Justification |
|---|---|---|
| Consultations for any reason. May include administrative and other non-clinical events. | Rate (per patient-year) |
Capture general primary-care utilisation, expected to increase in year before diagnosis |
| Symptoms in primary care, as a composite | ||
| Consultations for any of 21 symptoms | Rate | Symptom consultations expected to increase more in year before diagnosis than general consultations |
| Proportion of patients with multiple distinct symptoms | Proportion | Hints partially at recording, i.e., if it is easy to record symptoms in one system then we might expect more patients with multiple symptoms |
| ‘Alarm’ symptoms in primary care | ||
| Consultations for any of 9 ‘alarm’ symptoms | Rate | Symptoms that are known to be relatively strongly associated with a specific cancer. Typically identified in clinical guidance as indicating urgent assessment for suspected cancer in at least some age groups. |
| Abdominal lump | Rate | |
| Breast lump | Rate | |
| Change in bowel habit | Rate | |
| Dysphagia | Rate | |
| Haematuria | Rate | |
| Haemoptysis | Rate | |
| Jaundice | Rate | |
| Post-menopausal bleed | Rate | |
| Rectal bleeding | Rate | |
| ‘Non-alarm’ symptoms in primary care | ||
| Consultations for any of 12 ‘non-alarm’ symptoms | Rate | Symptoms that are possibly related to a cancer diagnosis, perhaps of specific sites (e.g., abdominal pain and colorectal cancer) or of a range of sites (e.g., fatigue), but which are also common in primary care for other non-cancer reasons. |
| Abdominal bloating | Rate | |
| Abdominal pain | Rate | |
| Constipation | Rate | |
| Cough | Rate | |
| Diarrhoea | Rate | |
| Dyspepsia | Rate | |
| Dyspnoea (shortness of breath) | Rate | |
| Fatigue | Rate | |
| Night sweats | Rate | |
| Pelvic pain | Rate | |
| Nausea / vomiting | Rate | |
| Weight loss | Rate | |
| Blood tests in primary care | ||
| Any of the below blood tests | Rate | Especially for ‘non-alarm’ symptoms, blood tests in primary care may provide useful information for decision-making by GPs and indicate the possibility of cancer. |
| Haemoglobin concentration | Rate | |
| Platelet counts | Rate | |
| Haematocrit percentage | Rate | |
| Albumin | Rate | |
| Ferritin | Rate | |
| ESR | Rate | |
| CRP | Rate | |
| PV | Rate | |