Abstract 6752: Patient (pt) characteristics, diagnostic journey, and cancer enrichment among pts with nonspecific signs and/or symptoms (s/sx) in the US community oncology setting: a real-world retrospective study
Authors: Benton Christopher , He Ding , Todoroff Karen , Coignet Marie V. , Luan Ying , Kurtzman Kathryn N. , Zackon Ira 
Published: April 2023

Of the &gt;1.6 million people diagnosed with cancer in the US each year, &gt;60% are diagnosed after symptomatic presentation, including nonspecific s/sx. These nonspecific s/sx may cause pts to undergo unnecessary diagnostic evaluation while the possibility of cancer and search for its origin is explored, causing delayed treatment and poor outcomes. Additionally, pts who do not have cancer are often subjected to various undirected/misdirected procedures due to initial cancer suspicion. Our objective was to examine pt characteristics, diagnostic journey, and cancer incidence of pts with nonspecific s/sx within The US Oncology Network.

This retrospective observational cohort study included pts aged ≥40 with ≥1 of the following nonspecific s/sx in their problem list at their first visit within The US Oncology Network (index date) during the identification period from 1/1/2016 to 12/31/2020: anemia, venous thromboembolism, general malaise, weight loss, nonspecific abdominal symptoms, new and unexplained breathlessness, unexplained worsening pain, and abnormal lab test results. Pts were excluded if diagnosed with any cancer (except basal cell carcinoma and squamous cell carcinoma skin cancer) within 3 years prior to or on index date. Pts were followed longitudinally with data from electronic health records for initial cancer diagnosis (dx), death, end of study observation period, or 12 months, whichever occurred first. Demographic and clinical characteristics were assessed descriptively.

103,984 pts were identified. The median age was 65.7, 64% were female, 65% were White, 41% were obese, 47% were never smokers, and 48% were from a southern practice region. 6,774/103,984 pts (7%) were diagnosed with cancer and 6,537/6,774 (97%) with 1 primary cancer: 3,825/6,537 (59%) were diagnosed with a hematologic malignancy and 2,712/6,537 (41%) with a solid tumor cancer. Among pts diagnosed with primary solid tumors, 31% had gastrointestinal, 15% genitourinary, 15% respiratory, 13% breast, and 11% gynecologic cancer. Among pts diagnosed with cancer, median time to cancer dx after being referred to secondary care within The US Oncology Network with nonspecific s/sx was &gt;5 wks (solid: &gt;7 wks; hematologic: &gt;4 wks); by 17 and 34 wks, 75% and 90% of pts received a cancer dx, respectively.

Within this population of pts most frequently presenting with nonspecific hematologic s/sx and subsequent cancer dx, 40% were diagnosed with solid tumor cancers within 1 year. This speaks to the unmet need for more tools such as a multi-cancer detection test that could aid in detection of multiple cancers and faster diagnostic resolution of nonspecific s/sx. Given the impact of delayed cancer dx and timely treatment on outcomes, such a test could potentially substantially improve cancer care and diagnostic evaluations.

Citation Format: Christopher Benton, Ding He, Karen Todoroff, Marie V. Coignet, Ying Luan, Kathryn N. Kurtzman, Ira Zackon. Patient (pt) characteristics, diagnostic journey, and cancer enrichment among pts with nonspecific signs and/or symptoms (s/sx) in the US community oncology setting: a real-world retrospective study. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6752.