We aimed to understand the time period of cancer diagnosis and the cancer types detected in primary care patients with unexpected weight loss (UWL) to inform cancer guidelines.
This retrospective matched cohort study used cancer registry linked electronic health records from the UK's Clinical Practice Research Datalink from between 2000 and 2014. Univariable and multivariable time-to-event analyses examined the association between UWL, and all cancers combined, cancer site and stage.
In all, 63,973 patients had UWL recorded, of whom 1375 (2.2%) were diagnosed with cancer within 2 years (days-to-diagnosis: mean 181; median 80). Men with UWL (HR 3.28 (2.88-3.73)) and women (1.87 (1.68-2.08)) were more likely than comparators to be diagnosed with cancer within 3 months. The association was greatest in men aged ≥50 years and women ≥70 years. The commonest cancers were pancreas, cancer of unknown primary, gastro-oesophageal, lymphoma, hepatobiliary, lung, bowel and renal-tract. The majority were late-stage, but there was some evidence of association with stage II and stage III cancers. In the 3-24 months after presenting with UWL, cancer diagnosis was less likely than in comparators.
UWL recorded in primary care is associated with a broad range of cancer sites of early and late-stage.
British journal of cancer. 2020 Apr 15 [Epub ahead of print]
Brian D Nicholson, Willie Hamilton, Constantinos Koshiaris, Jason L Oke, F D Richard Hobbs, Paul Aveyard
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK. ., Medical School, University of Exeter, Exeter, UK., Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK.