QCancer may be built into GP systems

Algorithms designed to help the early detection of cancer may be integrated into GP IT systems.

Professor Julia Hippisley-Cox, of Nottingham University, is leading a project on QCancer algorithms, which uses data from the QResearch database system – a not-for-profit partnership between Nottingham University and EMIS.

EMIS has already committed to integrating the algorithms into its clinical systems if there is demand from GPs.

There are five published QCancer scores. The simple online calculators are used to predict people most at risk of certain types of cancer at an early stage by assessing their symptoms and risk factors.

A study into the effectiveness of the most recent QCancer score for ovarian cancer, published last week by the British Medical Journal, showed it was successful in predicting almost two-thirds of ovarian cancers in the 10% of women who were most at risk of having the disease over a two year period.

Professor Hippisley-Cox said there had been strong interest in the project from GPs and cancer charities as it was in line with national priorities for improving early diagnosis of cancer and increasing access for GPs to diagnostic testing.

She explained the idea was to eventually integrate the tools into all GP clinical systems to be used in two ways.

If a patient consulted a GP with a relevant symptom, a template would appear on the doctor’s computer which would be used to complete the relevant information and present the GP and patient with risks of various cancers.

The information could be stored systematically within the patient’s record and used on the referral letter if something needed further investigation, she said.

Also, if integrated into the GP system, the Qcancer scores could be run in “batch mode” which enabled the entire practice population to be risk assessed in much the same as is already done for CVD or diabetes – using QRisk or QDscore.

“The computer can then generate a rank ordered list of patients and the GPs can assess those with the highest risks to see whether there have been any missed opportunities – for example a patient with alarm symptoms with a significant risk of cancer but who hasn’t been investigated or referred,” added Professor Hippisley-Cox.

QCancer is available for all NHS IT suppliers and has been designed so it can be integrated on a range of IT platforms.

Hippisley-Cox said the EMIS National User Group was keen to see QCancer integrated into the clinical system and EMIS had responded that it would be implemented if there was sufficient demand from GPs.

“For other clinicians using other systems, we have recommended they get in touch with the relevant systems suppliers as we are keen that QCancer is widely available regardless of systems, assuming clinicians find it beneficial,” she said.

“There is good evidence that earlier diagnosis of cancers increases treatment options and is associated with better survival.” The algorithms can be found at www.qcancer.org.