Symptoms at lung cancer diagnosis are associated with major differences in prognosis

This retrospective cohort study investigated survival of lung cancer patients between 1997 and 2011, according to symptoms at presentation. Ten symptom groups were identified, comprising the most common symptomatic presentations. The median survival of the 3800 cases of lung cancer was 183 days. There was a statistically significant difference in survival between the symptom groups both with and without adjustment for sex, age and histology. Compared to the cough-alone group, the risk of dying was significantly higher for the groups presenting with breathlessness, systemic symptoms, weight loss, chest pain, cough with breathlessness, neurological symptoms and other symptom combinations. The prognosis for symptomatic patients presenting with cough had a median survival approximately twice as long as that seen after any other symptomatic presentation. Although further research is needed into the value of expediting patients complaining of cough in its various forms, these symptoms should be highlighted in future awareness campaigns.

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