The association between unexpected weight loss and cancer diagnosis in primary care: a matched cohort analysis of 65,000 presentations

Many countries have developed guidelines to assist general practitioners (GPs) recognize alarm symptoms for early cancer diagnosis. However, many patients present with non-specific symptoms, such as unexpected weight loss (UWL), and often have longer times to diagnosis. This study aimed to understand time to diagnosis and cancer types detected in primary care patients with unexpected weight loss to inform cancer guidelines. The study examined a match cohort from the UK’s Clinical Practice Research Datalink. Of 63,937 patients with UWL recorded, 2.2% were diagnosed with cancer within 2 years. Time to diagnosis was also significantly shorter in patients with UWL. The most common cancers were pancreas, cancer of unknown primary, gastro-oesophageal, lymphoma, hepatobiliary, lung, bowel and renal-tract. Previous studies have shown that health-care systems are typically focused on investigating individual cancer sites based on specific alarm symptoms. These results show that UWL is associated with several cancer sites, thus a broader investigative strategy may be better suited rather than focusing on single cancer investigations. Such knowledge could inform future cancer guidelines to better cancer diagnostic pathways.

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