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Cancer diagnostic tools are currently not widely used in the UK and there is limited evidence on their impact on patient outcomes, while survival benefits drive cost-effectiveness but are unknown.

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Antonieta Medina-Lara 1,*, Bogdan Grigore 2, Ruth Lewis 3, Jaime Peters 2, Sarah Price 4, Paolo Landa 1, Sophie Robinson 5, Richard Neal 6, William Hamilton 4, Anne E Spencer 1

1 Health Economics Group, College of Medicine and Health, University of Exeter Medical School, Exeter, UK
2 Exeter Test Group, College of Medicine and Health, University of Exeter Medical School, Exeter, UK
3 North Wales Centre for Primary Care Research, Bangor University, Bangor, UK
4 Primary Care Diagnostics, College of Medicine and Health, University of Exeter Medical School, Exeter, UK
5 Peninsula Technology Assessment Group, College of Medicine and Health, University of Exeter Medical School, Exeter, UK
6 Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
* Corresponding author Email: A.Medina-Lara@exeter.ac.uk

Declared competing interests of authors: William Hamilton has overseen the development of a suite of cancer risk assessment tools encompassing all the major adult cancers. Richard Neal has also contributed to some of these studies. The risk assessment tools are available at no cost to the NHS. William Hamilton is the chief investigator of the Electronic Risk Assessment Tools for Cancer (ERICA) trial, a philanthropically funded cluster randomised controlled trial of electronic risk assessment tools in primary care. As a result of this interest, William Hamilton excluded himself from the data analysis, although he contributed to the rest of the work, including writing the outputs. Anne E Spencer and Antonieta Medina-Lara also report supporting the ERICA trial. William Hamilton, Antonieta Medina-Lara and Anne E Spencer report grants from Gillings Foundation and minor support from Cancer Research UK for the ERICA trial. Antonieta Medina-Lara reports grants from the National Institute for Health Research during the conduct of the study and outside the submitted work.

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