Clinical guidelines include monitoring blood test abnormalities to identify patients at increased risk of undiagnosed cancer. Noting blood test changes over time may improve cancer risk stratification by considering a patient’s individual baseline and important changes within the normal range. We aimed to review the published literature to understand the association between blood test trends and undiagnosed cancer. MEDLINE and EMBASE were searched until 15 May 2023 for studies assessing the association between blood test trends and undiagnosed cancer. We used descriptive summaries and narratively synthesised studies. We included 29 articles. Common blood tests were haemoglobin (24%, n = 7), C-reactive protein (17%, n = 5), and fasting blood glucose (17%, n = 5), and common cancers were pancreatic (29%, n = 8) and colorectal (17%, n = 5). Of the 30 blood tests studied, an increasing trend in eight (27%) was associated with eight cancer types, and a decreasing trend in 17 (57%) with 10 cancer types. No association was reported between trends in 11 (37%) tests and breast, bile duct, glioma, haematological combined, liver, prostate, or thyroid cancers. Our review highlights trends in blood tests that could facilitate the identification of individuals at increased risk of undiagnosed cancer. For most possible combinations of tests and cancers, there was limited or no evidence.
临床指南建议通过监测血液检测异常来识别未确诊癌症风险增加的患者。通过考虑患者的个体基线水平和正常范围内的显著变化，追踪血液检测指标随时间的变化趋势可能有助于改善癌症风险分层。本研究旨在回顾已发表文献，以探讨血液检测趋势与未诊断癌症之间的关联。我们检索了截至2023年5月15日的MEDLINE和EMBASE数据库，筛选评估血液检测趋势与未诊断癌症关联的研究，采用描述性总结和叙述性综合方法进行分析。共纳入29篇文献，涉及常见血液检测指标包括血红蛋白（24%，n=7）、C反应蛋白（17%，n=5）和空腹血糖（17%，n=5）；常见癌症类型为胰腺癌（29%，n=8）和结直肠癌（17%，n=5）。在研究的30项血液检测指标中，8项指标（27%）的上升趋势与8种癌症类型相关，17项指标（57%）的下降趋势与10种癌症类型相关。另有11项检测指标（37%）的趋势与乳腺癌、胆管癌、胶质瘤、血液系统联合癌症、肝癌、前列腺癌或甲状腺癌未发现显著关联。本综述揭示了血液检测趋势在识别未确诊癌症高风险个体中的潜在价值，但多数检测指标与癌症组合的证据仍有限或缺失。
肿瘤(癌症)患者之家