Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

A pioneering study into myeloma, a rare cancer, could lead to GPs using simple blood tests to improve early diagnosis.

If abnormalities are detected in this test, it should lead to urgent urine protein tests which can help speed up diagnosis.
- Constantinos Koshiaris, University of Oxford

A pioneering study into myeloma, a rare cancer, could lead to GPs using simple blood tests to improve early diagnosis.

The study investigated the best combination of blood tests that could be used to diagnose myeloma in GP practices.

The research was a collaboration between the University of Oxford, the University of Exeter and Chiddenbrook Surgery, Crediton, funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health and Research (CLAHRC) Oxford, and is published in the British Journal of General Practice.

Researchers investigated how useful a number of different measures were for indicating the presence of the disease, and suggested what combinations of these tests were sufficient to rule out the disease, and to diagnose it, saving the patient from the worry of specialist referral.

Blood tests of 2703 cases taken up to five years prior to diagnosis were analysed and compared with those of 12,157 patients without the cancer, matching cases with control patients of similar age amongst other relevant parameters.

They demonstrated that a simple combination of two blood parameters could be enough to diagnose patients. Such blood tests are routinely conducted in GP surgeries.

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 rule out myeloma. If abnormalities are detected in this test, it should lead to urgent urine protein tests which can help speed up diagnosis."

Each year approximately 5,700 people are diagnosed with myeloma in the UK alone. It can lead to symptoms such as bone pain, fatigue and kidney failure.  It has the longest diagnosis process of all common cancers, and a large number of patients are diagnosed after emergency care, over a third of which having had at least three primary care consultations.

Professor Willie Hamilton, of the University of Exeter Medical School, is principal investigator on the study. He said “Ordinarily a GP will see a patient with myeloma every five years – and early diagnosis matters. More timely treatment could significantly improve survival rates for this disease. We report a simple way a GP can check patients presenting symptoms such as back, rib and chest pain, or recurrent chest infections, and determine whether they have myeloma or not”.

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.

Read online:

Early detection of multiple myeloma in primary care using blood tests: a case–control study in primary care
Constantinos Koshiaris, Ann Van den Bruel, Jason L Oke, Brian D Nicholson, Elizabeth Shephard, Mick Braddick and William Hamilton
Br J Gen Pract 13 August 2018; bjgp18X698357. DOI: https://doi.org/10.3399/bjgp18X698357

Similar stories

DPhil alumna awarded Mildred Blaxter Fellowship for medical sociology research

Policy & health systems Students

Congratulations to Dr Caitlin Pilbeam, a medical anthropologist and postdoctoral researcher in the Department, who has been awarded the Mildred Blaxter Fellowship from the Foundation for the Sociology of Health and Illness.

Inhaled corticosteroids to be investigated as a possible treatment for Covid-19 in national PRINCIPLE Trial

COVID-19 Clinical trials Infection & acute care

In Covid-19, inhaled budesonide may prevent damaging inflammation, stop the virus from getting into lung cells and inhibit viral replication.

Early birth linked to greater risk of hospital visits during childhood

Policy & health systems Research methods & EBM

Findings indicate that gestational age at birth is a strong predictor of ill health throughout childhood

Primary Care Health Sciences Scholars Programme launches

Students

The Nuffield Department of Primary Care Health Sciences’ first scholarship programme launches to support students wishing to pursue either the DPhil in Primary Health Care or DPhil in Translational Health Sciences.

Oxford to trial new COVID-19 test for individuals without symptoms

COVID-19 Infection & acute care

Led by a research team in the Nuffield Department of Primary Care Health Sciences, the University of Oxford will take part in a new pilot scheme to assess the use of Lateral Flow Tests (LFTs), a new COVID-19 test designed to identify asymptomatic individuals with the virus.

Welcoming our new DPhil students to the department!

Students

The new academic year brings a new set of DPhil students into the department. Some are entirely new to us, some have been working in the department in the last few years, and all are very welcome.