CANARY (CANcer risk in patients with unexpected weight loss in primaRY care) Studies: Clinical Decision Support Systems for Cancer Prevention and Early Cancer Detection in Primary Care

General practitioners address many conditions in their day-to-day practice. There are more than 100 frequent conditions that need to be addressed by GPs in primary care. Unexpected weight loss is one of those conditions. It has proven to be a risk factor for cancer, and yet, most of the time, its presence will not lead to a cancer diagnosis. Nonetheless, the challenges of considering a cancer diagnosis in the presence of non-specific symptoms and mildly abnormal standard test results can lead to missed opportunities to diagnose cancer early in primary care.

Primary care practices, through their Electronic Medical Record systems (EMRs) hold an immense amount of information regarding patients’ personal and family history, signs, symptoms, and pathology test results through time. This information can be stored in primary care datasets and used to improve care in general practice.

A previous collaboration at the University of Melbourne and Western Health called Future Health Today (FHT), allowed us to develop simple models to identify patients at risk of undiagnosed cancer using abnormal blood test results in primary care. In this new set of studies, we will enrich these models by adding other features, like symptoms and additional abnormal test results to identify patients that may be at risk of undiagnosed cancer. In particular, we are closely working with UK researcher Dr. Brian Nicholson and his team at the University of Oxford, to validate their risk prediction model based on unexpected weight loss as a risk factor for cancer in Australian populations.

This research will develop and implement a new tool that will prompt GPs to promptly investigate patients who may be at risk of undiagnosed cancer, using information available in the medical records. We hope to improve early cancer detection and cancer outcomes in general practices throughout Australia.

Project Leader: Dr. Javiera Martinez Gutierrez

Herman Prof Jon Emery, Academic GP, University of Melbourne

Dr. Alex Lee, Research Fellow, University of Melbourne

Ms. Sophie Chima, Graduate researcher, University of Melbourne

Ms. Deborah Daly, Consumer Investigator

Dr. George Fishman, Consumer Investigator

A/Prof Jo-Anne Manski-Nankervis, Academic GP, University of Melbourne

Dr. Barbara Hunter, Qualitative research Fellow, University of Melbourne

Dr. Craig Nelson, Nephrologist, University of Melbourne, and Western Health

Dr. Brian Nicholson, Academic GP, University of Oxford

Mr. Chris Kearney, Project manager, Victoria Comprehensive Cancer Centre

Mr. Philip Ly, Research Assistant, University of Melbourne

Dr. Fong Seng Lim, Academic GP, National University of Health Systems, Singapore

Mr. Benny Wang Zhengjie, Project manager, Singapore Primary Care Cancer Network ( SPriNT).

Primary Care Collaborative Cancer Clinical Trials Group (PC4)

FHT General practice advisory group

FHT Consumer advisory group

FHT is a collaboration between The University of Melbourne and Western Health (https://futurehealthtoday.com.au). This research is supported by the Medical Research Future Fund’s Rapid Applied Research Translation program in conjunction with the Melbourne Academic Centre for Health and the Paul Ramsay Foundation.

Dr. Javiera Martinez Gutierrez is supported by the Victorian Cancer Agency Mid-Career Fellowship and the Australian Government Research Training Program.