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The University of Southampton
CANcer Diagnosis Decision rules (CANDID)

Information for Primary Care Staff

This research is about finding what symptoms and examinations are best for predicting lung and bowel cancer. It is funded by the National Institute for Health Research (NIHR) National School of Primary Care Research (NSPCR). This is a multi-centre study and will be coordinated from the University of Southampton by a team led by Professor Paul Little. Recruitment opened in July 2013 and will continue until September 2015.

In primary care the key areas of concern for both doctor and patients are delay in diagnosing cancer, getting high risk patients referred first, and keeping investigation to a minimum. There have been few valid studies to assist decision-making in primary care, either to get a patient referred quickly or to assist in making sure an anxious patient is effectively reassured. This study seeks to work out which of the symptoms and examination findings are the most effective in predicting lung or colon cancer.

To decide the best clinical information to collect in the study we will interview patients and also get consensus from a group of experts. Then we will recruit 20,000 patients who consult their GP - half with lung symptoms and the other half with low bowel symptoms. Clinical information will be collected using standardised internet based forms. Willing patients will complete lifestyle questionnaires and provide blood or saliva samples (including for genetic analysis). The National Cancer Registry will then be monitored to see which patients develop cancer, and statistical analysis will determine the most important clinical variables that predict cancer. The clinical prediction 'rules' or decision aids developed from these studies will then be tested with a further 2000 patients for each condition for validity.

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