In the UK, myeloma incidence has increased by 30% since the 1990s and 5700 cases of myeloma are diagnosed every year. However, possibly because the symptoms are non-specific, patients with myeloma have the longest intervals from initial symptom reporting to diagnosis of all common cancers, with the most consultations in primary care before referral.
Researchers at Oxford University, the University of Exeter and Chiddenbrook Surgery, Crediton have collaborated to try to improve myeloma diagnosis. Using a case-control study of 2,703 myeloma cases and 12,157 matched controls, they investigated how useful a number of different routine blood-based measures were for indicating the presence of the disease. Their work, published in the British Journal of General Practice, demonstrated that a simple combination of two blood parameters – plasma viscosity or erythrocyte sedimentation rate and haemoglobin levels - could be sufficient to diagnose patients.
Dr Brian D Nicholson, clinical researcher at the Nuffield Department of Primary Care in Oxford, and co-author of the study stated: “We wanted to develop a simple rule based on existing commonly used blood tests to help GPs identify which patients should be investigated further for Myeloma. By achieving this we offer guidance that can be implemented immediately in routine primary care to benefit all patients.”
Constantinos Koshiaris, lead author of the study, from Oxford University, said: “The combination of levels of haemoglobin, the oxygen carrier in the blood, and one of two inflammatory markers (erythrocyte sedimentation rate or plasma viscosity) are a sufficient test to rule out myeloma. If abnormalities are detected in this test, it should lead to urgent urine protein tests which can help speed up diagnosis.”
The authors also suggest the possibility of integrating a system in the electronic health record to alert clinicians to relevant symptoms or changes in blood parameters related to myeloma.
For more information, see the news story on the University of Oxford website.
This work is funded by the Primary Care Research Trust and: