为癌症调查优先考虑初级保健患者意外体重减轻:诊断准确性研究 (更新)
Brian D Nicholson1, Pradeep Virdee2, Paul Aveyard2
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK brian.nicholson@phc.ox.ac.uk.
概括
年轻人意外减肥有较低的癌症风险 (<3%). 然而,老年人 (男性≥50,女性≥60) 和具有特定症状的年轻人需要进行癌症检查.
科学领域:
- 在瘤学瘤学.
- 诊断的准确性 诊断的准确性
- 初级医疗保健医学 一级医疗保健医学
背景情况:
- 意想不到的体重减轻是一种令人担忧的症状,可能表明潜在的恶性瘤.
- 量化癌症减肥的预测值对于适当的诊断策略至关重要.
研究的目的:
- 评估癌症意外减肥的预测价值.
- 根据患者的人口统计 (年龄,性别,吸烟状况) 和并发的临床特征来分析这一预测值.
主要方法:
- 一项使用来自英格兰的电子健康记录进行的诊断准确性研究.
- 包括超过326,000名成年人,他们有意想不到的减肥代码.
- 在减肥指数日期后六个月内诊断出癌症的分析以及相关的临床特征.
主要成果:
- 在4.8%的人群中,癌症被诊断为意外减肥的个体.
- 在50岁以上的男性和60岁以上的女性中观察到更高的癌症风险.
- 特定的临床特征和异常的血液测试 (例如,低白蛋白,血小板升高) 增加了癌症的可能性.
结论:
- 仅仅是意想不到的体重减轻并不需要在年轻人 (<3%的癌症风险) 中进行紧急调查.
- 年龄≥50岁的男性,年龄≥60岁的女性和具有并发临床特征的年轻患者应进行癌症检查.
- 与减肥相关的临床特征可以表明多种癌症类型,而不仅仅是通常与症状相关的癌症.
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