A scoping review of unexpected weight loss and cancer: risk guidelines and recommendations for follow-up in primary care.

Unexpected weight loss (UWL) is a common symptom that can be associated with undiagnosed cancer, yet there is a lack of consistency in clinical guidelines for its assessment in primary care settings. A scoping review aimed to synthesise evidence on the link between UWL and cancer, and to evaluate existing guidelines and recommendations for managing patients presenting with this symptom. The review involved a systematic search of four databases for peer-reviewed literature from 2012 to 2023 and included 25 studies with over 916,000 patients. The findings revealed that 92% of the studies provided strong evidence connecting UWL with undiagnosed cancer. The National Institute for Health Care and Excellence (NICE) Cancer Guideline was commonly referenced, and general recommendations included regular weight monitoring, evaluation of family history, risk factors, additional symptoms, and comprehensive physical exams. The review highlighted common diagnostic tests and procedures recommended for patients with UWL, such as C-reactive protein, complete blood count, alkaline phosphatase, and thyroid-stimulating hormone tests, as well as immunochemical fecal occult blood tests, abdominal ultrasound, and chest X-rays. One large cohort study offered specific recommendations based on age, sex, and differential diagnosis. The review’s findings are intended to guide the development of a computer decision support tool to improve the assessment of UWL in primary care, potentially leading to earlier cancer detection and better patient outcomes. You can read the full article here.