# Cancer risk scores running automatically in GP records to prompt urgent referral

Source: https://onco.cc/ideas/idea-prev-ehr-symptom-signature-prompts/  
OnCo record `idea-prev-ehr-symptom-signature-prompts` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Computers can combine minor symptoms, blood tests and age into a cancer risk score in the background. Showing that score to the GP could get more people referred earlier.

## Summary

QCancer and similar algorithms exist but are rarely used because they need manual entry. Propose EHR-embedded, passively computed risk scores with a threshold-triggered prompt, tested in a randomised trial with stage at diagnosis and emergency presentation as endpoints, following the template of the UK ERICA cluster trial.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Passive risk-score prompts increase the proportion of cancers diagnosed at stage I-II by at least 5 percentage points and reduce emergency presentations by at least 15% without doubling referral volume.
- Rationale: The evidence gap is implementation, not algorithm accuracy.
- Proposed test: Cluster RCT across 500 practices over two years with registry-linked outcomes.
- Maturity: early-clinical
- Actor: clinic

## Sources

- Bottleneck evidence (The hardest cancers are found late): Crosby et al., Early detection of cancer (Science 2022): https://doi.org/10.1126/science.aay9040

## Connected records

- fronts: [Early Detection & Screening](https://onco.cc/fronts/early-detection/)
- bottlenecks: [Fragmented care and guideline gaps](https://onco.cc/bottlenecks/b-care-fragmentation/), [The hardest cancers are found late](https://onco.cc/bottlenecks/b-early-detection/)
- key papers: [Early detection of cancer](https://onco.cc/key-papers/paper-crosby-science/)

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