RDC Biomarker Study

Rapid Diagnostic Centres Rapid Diagnostic Centres (RDC) were built to diagnose patients who have common symptoms that occur in cancer, but it is unclear if they have cancer or not. These symptoms include: * Weight loss * Fatigue * Cough * GP suspicion Only 1 in every 10 patients (10%) referred to an RDC will have cancer. Some of the patients with cancer may have been more likely to develop cancer due to inherited or environmental factors. Some of the patients who don't have cancer may also be at higher risk of developing cancer at another time due to inherited or environmental factors. Aims The goal of this observational study is to develop a new blood or non-blood test that could help doctors at RDC: * detect which patients have cancer through a simple and quick blood or non-blood test * detect patients who are at higher risk of having cancer. This is so they can be monitored or guided towards cancer-screening programmes Main End Points * The study will be considered a success if a test or mixture of tests is developed that can correctly sort patients into cancer or non-cancer groups. * Also, the study will be considered a success if a test or mixture of tests can show what type of cancer a patient has if they have cancer. Tests To create this new blood or non-blood test the study will take the following samples from 1000 patients in the RDC Biomarker Study: * Breath samples (around 300 patients) - People with cancer have different levels of chemicals in their breath than people without cancer. The study hopes to develop a breath test which could show if a patient has cancer or not. * Blood samples ( around 1000 patients) - The study hopes to develop a blood test that could show if a patient has cancer or not * Saliva samples (around 1000 patients) - For many cancers, while there is a genetic component there is no one single gene that causes cancer. Instead, it can be a combination of hundreds of genes that causes the risk of cancer in a person to go up. The study hopes to develop a test which could provide a risk score. This risk score is called a 'polygenic risk score' which would tell doctors how likely a patient is to get cancer. Method Patients who meet the criteria to be able to join the study will be asked either via telephone before their appointment, or face-to-face at an appointment at the RDC if they would like to join the study. If they agree to join the study they will read a patient information sheet and sign a consent form to say they understand what the study requires. The patient will then provide blood and saliva samples and in some cases breath samples at their first appointment. They will be then asked to provide further samples (up to three) at their follow-up appointments. Please see below for samples that will be asked for at each appointment: First appointment: Breath (not all sites), Blood, Saliva (not all sites), Survey Follow-up 1: Any samples that could not be taken at the first appointment Follow-up 2: Any samples that could not be taken at the first appointment The patient will be provided with a Study ID to identify their samples. This is a unique code to identify each person on the study. Only the site that recruited the participant will have access to the personal information that matches which patients is known by which Study ID. All organisations external to the site will only know the patient as the Study ID. An example of the study ID could be RDCRMH001. A trained clinical member of the research team at the RDC will take the sample and ship it to the relevant laboratory for testing. As well as blood and non-blood tests, information about the patients will be collected This includes routinely collected clinical data alongside investigation results. No patient identifiable information such as: * Name * Address * Date of birth * Contact details will be collected, and a Study ID will be used to identify the data. A patient questionnaire will be sent out to patients to complete for each appointment asking questions about the patient's health. The RDC doctors treating the patient will see survey answers before the appointment to allow them to act about anything worrying. For a small group of patients anonymised copies of thier scans from their medical records will also be taken. Study Duration Once the study has recruited 1000 patients, it will close to recruitment. These patients will then be followed up for 12 months following the date they joined the study.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* Patients referred to undergo investigation for suspected cancer within a non-tumour site specific RDC
* Age \> 18 years

Exclusion Criteria:

* Previously treated (treatment completed within 5 years preceding recruitment)
* Current confirmed diagnosis of active malignancy
* Unable to or unwilling to give informed consent

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