Thrombocytosis helps to stratify risk of colorectal cancer in patients referred on a 2-week-wait pathway

Bailey, J. A.; Hanbali, N.; Premji, K.; Bunce, J.; Mashlab, S.; Simpson, J. A.; Humes, D. J.; Banerjea, A.

Abstract

Purpose
Primary care studies suggest that thrombocytosis (platelet counts > 400 × 109/L) is associated with an increased risk of colorectal cancer (CRC). We aimed to establish whether this marker has significant stratification value in patients seen in secondary care.

Methods
A retrospective review of 2991 patients referred to our colorectal 2-week-wait (2WW) pathway between August 2014 and August 2017. Patient demographics were recorded prospectively, and local electronic records systems were used to retrieve full blood counts (FBC) and cancer diagnoses. Patients with no recent platelet count at the time of referral or incomplete records were excluded.

Results
2236 patients were included in this evaluation. There was no significant difference in the age distribution of those with thrombocytosis and those without. There were significantly more females in the thrombocytosis group (72.1% vs 53.9%, chi-squared 24.63, p < 0.0001). 130 CRCs were detected (5.8%) and patients with thrombocytosis were more likely to have CRC (OR 2.62, 95% CI 1.60–4.30). The CRC diagnosis rate was significantly higher in females with thrombocytosis (10.3% vs 2.9%, chi-squared 19.41, p < 0.0001) and males with thrombocytosis (16.1% vs 7.9%, chi-squared 4.62, p = 0.032).

Conclusion
Thrombocytosis appears to have stratification value in the 2WW population. Further evaluation of its value alone or in combination with other stratification tests is required.

Citation

Bailey, J. A., Hanbali, N., Premji, K., Bunce, J., Mashlab, S., Simpson, J. A., Humes, D. J., & Banerjea, A. (2020). Thrombocytosis helps to stratify risk of colorectal cancer in patients referred on a 2-week-wait pathway. International Journal of Colorectal Disease, 35(7), 1347-1350. https://doi.org/10.1007/s00384-020-03597-9

• Journal Article Type: Article
• Acceptance Date: Apr 13, 2020
• Online Publication Date: May 1, 2020
• Publication Date: 2020-07
• Deposit Date: May 6, 2020
• Publicly Available Date: May 6, 2020
• Journal: International Journal of Colorectal Disease
• Print ISSN: 0179-1958
• Electronic ISSN: 1432-1262
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 35
• Issue: 7
• Pages: 1347-1350
• DOI: https://doi.org/10.1007/s00384-020-03597-9
• Keywords: Gastroenterology
• Public URL: https://nottingham-repository.worktribe.com/output/4385457
• Publisher URL: https://link.springer.com/article/10.1007%2Fs00384-020-03597-9