Weight Loss as an Untapped Early Detection Marker in Pancreatic and Periampullary Cancer

Hue, Jonathan J.; Sugumar, Kavin; Kyasaram, Ravi Kumar; Shanahan, John; Lyons, Joshua; Ocuin, Lee M.; Rothermel, Luke D.; Hardacre, Jeffrey M.; Ammori, John B.; Rao, Goutham; Winter, Jordan M.; Markt, Sarah C.

doi:10.1245/s10434-021-09861-8

Cited by 30 publications

(29 citation statements)

References 43 publications

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“…Second, and perhaps more importantly, depression and anxiety appear to be underdiagnosed in cancer patients, as observed in this series and others 12,29,30 . These data exhibit a similar pattern with other nonspecific presenting signs and symptoms of PC, such as unintentional weight loss, which are also often overlooked 13,31 . Thus, rigorous evaluation of these nonspecific signs and symptoms offer a potential opportunity for earlier PC diagnosis.…”

Section: Discussionsupporting

confidence: 71%

“…12,29,30 These data exhibit a similar pattern with other nonspecific presenting signs and symptoms of PC, such as unintentional weight loss, which are also often overlooked. 13,31 Thus, rigorous evaluation of these nonspecific signs and symptoms offer a potential opportunity for earlier PC diagnosis.…”

Section: T a B L Ementioning

confidence: 99%

“…12 Physicians may underappreciate that PC is frequently foreshadowed by depression or anxiety, similar to presenting signs like unintentional weight loss or new-onset or worsening diabetes. 4,13 The first reported observation of prodromal psychiatric symptoms was published in 1931. Four patients developed diverse psychiatric symptoms (e.g., anxiety, depression, restlessness, anorexia, fatigue, insomnia, or nervousness) prior to diagnosis of PC.…”

Section: Introductionmentioning

confidence: 99%

“…Physicians may underappreciate that PC is frequently foreshadowed by depression or anxiety, similar to presenting signs like unintentional weight loss or new‐onset or worsening diabetes 4,13 . The first reported observation of prodromal psychiatric symptoms was published in 1931.…”

Section: Introductionmentioning

confidence: 99%

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Prodromal depression and anxiety are associated with worse treatment compliance and survival among patients with pancreatic cancer

et al. 2022

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Objective To determine the frequency of depression or anxiety preceding a diagnosis of pancreatic cancer (PC). Further, to examine the association of PC‐associated depression or anxiety with treatment compliance and survival. Methods 856 patients with PC from a single institution were identified using International Classification of Diseases (ICD) codes. For each case, two non‐cancer age‐ and sex‐matched controls were included. Dates of depression or anxiety diagnosis identified using ICD codes were compared to the date of PC diagnosis. The medical record was queried to further explore psychiatric symptoms. Multivariable analyses were performed to examine if prediagnosis depression or anxiety was associated with receipt of treatment or survival. Results A greater proportion of patients with PC experienced depression or anxiety in the year preceding diagnosis than the overall frequency in controls (4.6% vs. 2.6%, p = 0.005) based on ICD codes. Patients with PC exhibited signs of prodromal depression or anxiety based on ICD codes, clinical documentation of psychiatric symptoms, or initiation of new psychiatric medications more often than controls (20.7% vs. 6.7%, p < 0.001). Prediagnosis depression or anxiety was associated with a reduced likelihood of receiving chemotherapy (OR = 0.58, p = 0.04). There was an associated decrease in overall survival among patients with metastatic disease who experienced depression or anxiety before PC diagnosis (HR = 1.32, p = 0.04). Conclusions The frequency of depression or anxiety among patients with PC was higher than the general population. Prediagnosis psychiatric symptoms were associated with reduced chemotherapy utilization and worse overall survival. Thus, timely identification and treatment of these symptoms may improve outcomes.

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Section: Discussionsupporting

confidence: 71%

Section: T a B L Ementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prodromal depression and anxiety are associated with worse treatment compliance and survival among patients with pancreatic cancer

et al. 2022

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“…This likely reflects cancer-related weight loss that can often precede diagnosis with up to 75% of cancer patients experiencing !5% weight loss in the year prior to diagnosis. 18 Although weight loss coupled with new-onset diabetes in patients older than 50 years has been linked to increased short-term risk of pancreatic cancer in previous studies, 19,20 we did not identify such an association with recent-onset diabetes among patients with AP. This may be due to the small sample of patients with new-onset diabetes (3.9%) in the present study.…”

Section: Discussioncontrasting

confidence: 63%

Clinical and Imaging Predictors of Pancreatic Cancer in Patients Hospitalized for Acute Pancreatitis

Luong¹,

Chen²,

Tran

et al. 2022

Gastro Hep Advances

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Cancer Diagnoses After Recent Weight Loss

Wang,

Babic,

Rosenthal

et al. 2024

JAMA

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ImportanceWeight loss is common in primary care. Among individuals with recent weight loss, the rates of cancer during the subsequent 12 months are unclear compared with those without recent weight loss.ObjectiveTo determine the rates of subsequent cancer diagnoses over 12 months among health professionals with weight loss during the prior 2 years compared with those without recent weight loss.Design, Setting, and ParticipantsProspective cohort analysis of females aged 40 years or older from the Nurses’ Health Study who were followed up from June 1978 until June 30, 2016, and males aged 40 years or older from the Health Professionals Follow-Up Study who were followed up from January 1988 until January 31, 2016.ExposureRecent weight change was calculated from the participant weights that were reported biennially. The intentionality of weight loss was categorized as high if both physical activity and diet quality increased, medium if only 1 increased, and low if neither increased.Main Outcome and MeasuresRates of cancer diagnosis during the 12 months after weight loss.ResultsAmong 157 474 participants (median age, 62 years [IQR, 54-70 years]; 111 912 were female [71.1%]; there were 2631 participants [1.7%] who self-identified as Asian, Native American, or Native Hawaiian; 2678 Black participants [1.7%]; and 149 903 White participants [95.2%]) and during 1.64 million person-years of follow-up, 15 809 incident cancer cases were identified (incident rate, 964 cases/100 000 person-years). During the 12 months after reported weight change, there were 1362 cancer cases/100 000 person-years among all participants with recent weight loss of greater than 10.0% of body weight compared with 869 cancer cases/100 000 person-years among those without recent weight loss (between-group difference, 493 cases/100 000 person-years [95% CI, 391-594 cases/100 000 person-years]; P &lt; .001). Among participants categorized with low intentionality for weight loss, there were 2687 cancer cases/100 000 person-years for those with weight loss of greater than 10.0% of body weight compared with 1220 cancer cases/100 000 person-years for those without recent weight loss (between-group difference, 1467 cases/100 000 person-years [95% CI, 799-2135 cases/100 000 person-years]; P &lt; .001). Cancer of the upper gastrointestinal tract (cancer of the esophagus, stomach, liver, biliary tract, or pancreas) was particularly common among participants with recent weight loss; there were 173 cancer cases/100 000 person-years for those with weight loss of greater than 10.0% of body weight compared with 36 cancer cases/100 000 person-years for those without recent weight loss (between-group difference, 137 cases/100 000 person-years [95% CI, 101-172 cases/100 000 person-years]; P &lt; .001).Conclusions and RelevanceHealth professionals with weight loss within the prior 2 years had a significantly higher risk of cancer during the subsequent 12 months compared with those without recent weight loss. Cancer of the upper gastrointestinal tract was particularly common among participants with recent weight loss compared with those without recent weight loss.

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Weight Loss as an Untapped Early Detection Marker in Pancreatic and Periampullary Cancer

Cited by 30 publications

References 43 publications

Prodromal depression and anxiety are associated with worse treatment compliance and survival among patients with pancreatic cancer

Prodromal depression and anxiety are associated with worse treatment compliance and survival among patients with pancreatic cancer

Clinical and Imaging Predictors of Pancreatic Cancer in Patients Hospitalized for Acute Pancreatitis

Cancer Diagnoses After Recent Weight Loss

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