Three symptoms ‘consistently associated’ with incurable cancer

Cancer symptoms: Top 14 early signs to look out for

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Cancer is a life-changing diagnosis. Just how life-changing the diagnosis proves to be depends on when the cancer is detected. Research published in The Lancet Oncology journal suggests three symptoms can be indicative of advanced cancer.


Researchers aimed to examine associations between common presenting symptoms of cancer and stage at diagnosis.

Researchers analysed population-level data from the English National Cancer Diagnosis Audit (NCDA) 2014 for patients aged 25 years and older with one of 12 types of solid tumours (bladder, breast, colon, endometrial, laryngeal, lung, melanoma, oral or oropharyngeal, ovarian, prostate, rectal, and renal cancer).

The NCDA provides an evidence-based audit tool to review pathways to cancer diagnosis, benchmark current practice and identify areas for improvement.

Researchers considered 20 common presenting symptoms and examined their associations with stage at diagnosis.

For each symptom, they estimated these associations when reported as a single presenting symptom and when reported together with other symptoms.

After analysing data on 7,997 patients, three of the examined symptoms were “consistently associated” with increased odds of stage stage 4 cancer, whether reported alone or with other symptoms.

These were:

  • Neck lump
  • Chest pain
  • Back pain.

What is stage 4 cancer?

According to Macmillan Cancer Support, advanced cancer usually means cancer that is “not possible to cure”.

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“For example, this may be because the cancer has spread to another part of the body.”

The proportion of patients diagnosed with stage 4 cancer varied substantially by presenting symptom, from one percent for abnormal mole to 80 percent for neck lump.

For 13 of the 20 symptoms, more than 50 percent of patients were diagnosed at stages other than stage 4.

These included:

  • Abnormal mole
  • Breast lump
  • Post-menopausal bleeding
  • Rectal bleeding
  • Lower urinary tract symptoms
  • Haematuria (blood in urine)
  • Change in bowel habit
  • Hoarseness
  • Fatigue
  • Abdominal pain
  • Lower abdominal pain
  • Weight loss
  • The “any other symptom” category.

For 19 of the 20 studied symptoms (all except for neck lump), more than a third of patients were diagnosed at stages other than stage 4.

“Despite specific presenting symptoms being more strongly associated with advanced stage at diagnosis than others, for most symptoms, large proportions of patients are diagnosed at stages other than stage IV,” the study researchers concluded.

“These findings provide support for early diagnosis interventions targeting common cancer symptoms, countering concerns that they might be simply expediting the detection of advanced stage disease.”

Spotting symptoms early

Early detection remains the most effective weapon in the fight against cancer.

Changes to your body’s normal processes or unusual, unexplained symptoms can sometimes be an early sign of cancer.

According to the NHS, early signs include:

  • A lump that suddenly appears on your body
  • Unexplained bleeding
  • Changes to your bowel habits.

“But in many cases your symptoms will not be related to cancer and will be caused by other, non-cancerous health conditions,” notes the health body.

It adds: “Although it’s unlikely to be cancer, it’s important to speak to a GP so they can investigate.”

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