Weight loss as a predictor of cancer in primary care

Weight loss can be associated with several cancer and non-cancer conditions, however there are currently no clinical guidelines for investigation. This systematic review is the first review of weight loss as a feature of cancer in non-specialist settings. 25 studies were included in the meta-analysis. Positive associations between weight loss and cancer were found for 10 cancer sites: prostate, colorectal, lung, gastro-oesophageal, pancreatic, non-Hodgkin’s lymphoma, ovarian, myeloma, renal tract, and biliary tree. Sensitivity ranged from 2% to 47%, and specificity from 92% to 99%, across cancer sites. Patients aged ≥60 years with unexpected weight loss have >3% chance of having cancer in one of 10 cancer sites. A GP’s decision to record weight loss is highly predictive of cancer. For such patients, urgent referral is justified to investigate for cancer across multiple sites.

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