Table 2

Types of clinical scenarios preceding the incidental diagnosis of cancer

Clinical scenarioDescription and examples
Monitoring or managing pre-existing chronic morbidityBlood or imaging investigations as part of monitoring or management of a chronic morbidity.
Eg, haematuria on dipstick urine testing [for diabetes] leading to diagnosis of bladder cancer.
Eg, annual blood tests for hypertension leading to diagnosis of leukaemia.
Before/after elective surgery for unrelated conditionsBlood or imaging investigations conducted before or after surgery, and more rarely, tumours identified in pathology specimens of tissue resected for other (benign) conditions.
Eg, pre-operative chest X-ray leading to diagnosis of lung cancer.
Eg, microscopic haematuria noted pre-cataract operation leading to diagnosis of a urological cancer.
Staging or follow-up for a previously diagnosed cancerBlood or imaging investigations carried out as part of staging or follow-up for a previously diagnosed cancer.
Eg, scans to ascertain stage at diagnosis of prostate cancer leading to the diagnosis of another urological cancer.
Investigation of unrelated acute or new condition/symptomsBlood or imaging investigations for a new or otherwise acute symptom or condition.
Eg, an abdominal ultrasound scan for dyspepsia leading to diagnosis of a urological cancer.
Eg, irregular mole noted during health check leading to diagnosis of melanoma.