Approved Research

Risk of death, cause-specific death, hematologic cancer, non-hematologic cancer and other adverse outcomes in individuals with incidentally discovered paraclinical tests indicating hematologic disease

Lay summary

The blood consists of cells such as the red blood cells, white blood cells and platelets. These blood cells are often measured as part of routine blood sampling in other contexts, and values both higher or lower than normal can indicate serious disease such as hematologic disease including hematologic cancer, but can also be caused by many other conditions. Likewise, the use of CT, ultrasound or MR scans of the stomach is steadily increasing, with an enlarged spleen often being a chance finding on a scan performed for other reasons. Enlarged spleen can be caused by hematologic disease including hematologic cancer, but can also be caused by several other conditions. The importance of these chance findings for an individual's health is not well studied. Currently, investigations for abnormal levels of blood cells or enlarged spleen in most cases require having a bone marrow biopsy performed to rule out hematologic disease including hematologic cancer. However, a bone marrow biopsy may not rule out other types of cancer or other disease. Using data available on general population individuals from the UK Biobank and the Copenhagen General Population Study, we will study risk of adverse outcomes in individuals with incidentally discovered blood test results that may indicate potential hematologic disease. Similarly, we will study risk of adverse outcomes in individuals with incidentally discovered hereditary accumulation of iron (called hereditary hemochromatosis) and in individuals with incidentally discovered enlarged spleen.

We seek to identify low- and high-risk individuals, to better the usage of diagnostic workup such as bone-marrow biopsy. For example, if we can identify a group of individuals as being at low-risk for hematologic cancer, future low-risk patients may avoid a bone-marrow biopsy, which can be an unpleasant and even painful procedure, and avoid the stress of worrying about being diagnosed with a serious condition, while focusing the workup on patients being at high-risk of disease. This could potentially lay ground for an evidence-based diagnostic algorithm guiding clinicians on when to refer individuals for further investigations. Such an algorithm may potentially benefit both patients that can avoid a potentially unnecessary diagnostic work-up, but can also be a substantial advantage for society as it may help to avoid extensive costs for unnecessary diagnostic workups.