Alarm symptoms of upper gastrointestinal cancer and contact to general practice – A population-based study

Rasmussen, Sanne; Larsen, Pia Veldt; Svendsen, Rikke Pilsgaard; Haastrup, Peter; Søndergaard, Jens; Jarbøl, Dorte Ejg

doi:10.3109/00365521.2015.1033745

Cited by 10 publications

(10 citation statements)

References 9 publications

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“…40 Conversely, repeated vomiting is 1 of the symptoms used to diagnose upper digestive cancer, because it is considered an alarm symptom. 41 In our study, vomiting also was the most prevalent NIS in patients with upper digestive cancer.…”

Section: Discussionsupporting

confidence: 53%

“…Nausea was higher in patients with gynecological cancer, and similar findings were reported in a conductive study at Aga Khan University Hospital, Pakistani, where 1 of the most common adverse effects was nausea (33.3%) in patients who received pelvic radiotherapy for gynecological cancer . Conversely, repeated vomiting is 1 of the symptoms used to diagnose upper digestive cancer, because it is considered an alarm symptom . In our study, vomiting also was the most prevalent NIS in patients with upper digestive cancer.…”

Section: Discussionmentioning

confidence: 48%

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High prevalence of malnutrition and nutrition impact symptoms in older patients with cancer: Results of a Brazilian multicenter study

Pinho

Martucci

Rodrigues

et al. 2019

Cancer

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Background Malnutrition in cancer is an independent factor associated with negative clinical outcomes. The objective of this study was to evaluate the prevalence of malnutrition across different age groups in patients with cancer in Brazil and to identify associations with nutrition impact symptoms (NIS). Methods In this observational, cross‐sectional, multicenter study, the authors evaluated 4783 patients with cancer aged ≥20 years who were admitted to 45 public hospitals in Brazil. Nutritional status, nutritional risk, and NIS were evaluated using the Patient‐Generated Subjective Global Assessment. Results More than one‐fourth (25.5%) of all participants were aged ≥65 years. In patients aged ≥65 years, the prevalence of moderate/suspected and severe malnutrition was 55%, it was 45.4% in those aged 51 to 64 years, and it was 36.1% in those aged ≤50 years. Among the NIS with a higher risk of occurrence in patients aged ≥65 years were no appetite (odds ratio [OR], 1.90; 95% CI, 1.62‐2.22; P < .05) and dry mouth (OR, 1.40; 95% CI, 1.1‐1.67; P < .05). In patients between ages 51 and 64 years, compared with those aged ≤50 years, the NIS with a higher risk of occurrence were no appetite (OR, 1.45; 95% CI, 1.23‐1.69; P < .05), dry mouth (OR, 1.22; 95% CI, 1.02‐1.45; P < .05), and problems with swallowing (OR, 1.56; 95% CI, 1.25‐1.96; P < .05). Conclusions The prevalence of malnutrition and the occurrence of NIS are high in hospitalized Brazilian patients aged ≥65 years who have cancer. The occurrence of NIS was higher in the population aged >50 years than in those aged ≤50 years. Nutritional screening and assessment should be performed immediately after hospitalization to enable early diagnosis and multidisciplinary or interdisciplinary intervention(s).

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 48%

High prevalence of malnutrition and nutrition impact symptoms in older patients with cancer: Results of a Brazilian multicenter study

Pinho

Martucci

Rodrigues

et al. 2019

Cancer

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“…The guidelines give access to fact track endoscopy for patients presenting specific alarm symptoms indicative of upper GI cancer such as blood in vomit and new onset dyspepsia in individuals over 45 years. We have previously reported that specific alarm symptoms of upper GI cancer are not very prevalent in the general population [ 6 ]. Much of the evidence supporting referral guidelines derive from secondary care settings and patients already diagnosed with upper GI cancer.…”

Section: Introductionmentioning

confidence: 99%

Predictive values of upper gastrointestinal cancer alarm symptoms in the general population: a nationwide cohort study

et al. 2018

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BackgroundSurvival rates for upper gastrointestinal (GI) cancer are poor since many are diagnosed at advanced stages. Fast track endoscopy has been introduced to prompt diagnosis for patients with alarm symptoms that could be indicative of upper GI cancer. However, these symptoms may represent benign conditions and little is known about the predictive values of alarm symptoms of upper GI cancer in the general population.MethodsThe study is a nationwide cohort study of 60,562 individuals aged 45 years or above randomly selected from the Danish general population. Participants were invited to complete a survey comprising of questions on several symptom experiences, including alarm symptoms for upper GI cancer within the past four weeks. The participants were asked about specific symptoms (repeated vomiting, difficulty swallowing, signs of upper GI bleeding or persistent and recent-onset abdominal pain) and non-specific symptoms (nausea, weight loss, loss of appetite, feeling unwell and tiredness).We obtained information on upper GI cancer diagnosed in a 12-month period after completing the questionnaire from the Danish Cancer Registry. We calculated positive predictive values and positive likelihood ratios for the association between alarm symptom and subsequent upper GI cancer.ResultsA total of 33,040 individuals above 45 years completed the questionnaire, yielding a response rate of 54.6%. Respondents were fairly respresentative of the study sample. During the follow-up period, 18 people were diagnosed with upper GI cancer. The number of incident cancers was similar among eligible non-respondents. Two thirds of the respondents with an upper GI malignancy had experienced one or more alarm symptoms.The positive predictive value for being diagnosed with upper GI cancer after reporting a least one alarm symptom was 0.1% (95% CI:0.0–0.1%). The positive likelihood ratio was 4.4 for specific alarm symptoms and 1.1 for non-specific alarm symptoms.ConclusionsWe found that positive predictive values of alarm symptoms of upper GI cancer experienced in the general population are low. It is important knowledge that despite denoted alarm symptoms even patients with specific alarm symptoms of upper GI cancer have a low risk of being diagnosed with upper GI cancer.

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“…Respecto a los síntomas, los más frecuentes encontrados para el CG fueron náuseas y vómito (52%), y dolor epigástrico (50%), lo cual fue similar a los reportados por varios autores, destacando que existen reportes superiores al 80% para dolor abdominal o epigástrico [8,11,13,14,16,17,18]. Sobre pérdida de peso, la frecuencia reportada fue del 31% de los pacientes, lo cual difiere a lo encontrado por otros autores de Estados Unidos [14], Dinamarca [19], Polonia [20] y Reino Unido [14]. En Colombia existía un estudio previo que la reportó en el 83% de los casos [12].…”

Section: Discussionunclassified

Características sociodemográficas y clínicas de pacientes con diagnóstico de cáncer de novo, que hicieron su ingreso por servicios de urgencias

Santacoloma¹,

Villegas²,

Guarnizo³

et al. 2019

archmed

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Objetivo: caracterizar sociodemográfica y clínicamente los pacientes que después de hacer su ingreso por servicios de urgencias de dos centros de tercer nivel de atención de la ciudad de Manizales (Colombia), se les diagnosticó alguno de los tipos de cáncer más frecuentes según el Registro Poblacional de Cáncer de Manizales. Método: con base a la información aportada por el Registro Poblacional de Cáncer de Manizales entre los años 2008 y 2012, se escogieron los cinco tipos de cáncer más frecuentes en cada género para la realización del estudio. Fueron incluidos 116 casos de los que hicieron su ingreso por servicios de urgencias para la extracción de información a partir de las historias clínicas, que posteriormente fue tabulada y analizada mediante estadística descriptiva. Resultados: la mayoría los pacientes provenían de Manizales (60,3%), y pertenecían al régimen contributivo de seguridad social (50,0%). El promedio de edad fue de 72,4 años. El promedio de duración de los síntomas antes de consultar fue de 2,3 meses; y los cánceres más frecuentes fueron el gástrico (41,4%), de colon (25,9%), CP (23,3%), cérvix (6%) y recto (3,5%) en estadios avanzados. Conclusiones: se continúan diagnosticando casos de cáncer de Novo en estadio tardío, al ingresar por los servicios de urgencias. Resulta muy importante conocer la epidemiologia de estos tipos de cáncer en cada una de las regiones y mejorar la formación médica con el fin de implementar estrategias para disminuir su presentación.

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Alarm symptoms of upper gastrointestinal cancer and contact to general practice – A population-based study

Cited by 10 publications

References 9 publications

High prevalence of malnutrition and nutrition impact symptoms in older patients with cancer: Results of a Brazilian multicenter study

High prevalence of malnutrition and nutrition impact symptoms in older patients with cancer: Results of a Brazilian multicenter study

Predictive values of upper gastrointestinal cancer alarm symptoms in the general population: a nationwide cohort study

Características sociodemográficas y clínicas de pacientes con diagnóstico de cáncer de novo, que hicieron su ingreso por servicios de urgencias

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