Skip to main content

Main menu

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • RESOURCES
    • About BJGP
    • Conference
    • Advertising
    • BJGP Blog
    • eLetters
    • Feedback
    • Librarian information
    • Alerts
    • Resilience
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
    • RCGP e-Portfolio

User menu

  • Subscriptions
  • Alerts
  • Log in

Search

  • Advanced search
British Journal of General Practice
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
    • RCGP e-Portfolio
  • Subscriptions
  • Alerts
  • Log in
  • Follow bjgp on Twitter
  • Visit bjgp on Facebook
  • Blog
British Journal of General Practice

Advanced Search

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • RESOURCES
    • About BJGP
    • Conference
    • Advertising
    • BJGP Blog
    • eLetters
    • Feedback
    • Librarian information
    • Alerts
    • Resilience
Research

Abdominal symptoms and cancer in the abdomen: prospective cohort study in European primary care

Knut Holtedahl, Peter Hjertholm, Lars Borgquist, Gé A Donker, Frank Buntinx, David Weller, Tonje Braaten, Jörgen Månsson, Eva Lena Strandberg, Christine Campbell, Joke C Korevaar and Ranjan Parajuli
Br J Gen Pract 9 April 2018; bjgp18X695777. DOI: https://doi.org/10.3399/bjgp18X695777
Knut Holtedahl
Department of Community Medicine, UiT The Arctic University of Norway, Norway.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Peter Hjertholm
Research Centre for Cancer Diagnosis in Primary Care, Aarhus University, Denmark.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lars Borgquist
Department of Medical and Health Sciences, Linköping University, Sweden.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gé A Donker
Sentinel Practices, NIVEL Primary Care Database, Utrecht, the Netherlands.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Frank Buntinx
Department of General Practice, KU Leuven, Belgium, and Maastricht University, the Netherlands.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
David Weller
Usher Institute of Population Health Sciences and Medical Informatics, University of Edinburgh, UK.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Tonje Braaten
Department of Community Medicine, UiT The Arctic University of Norway, Norway.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jörgen Månsson
Department of Public Health and Community Medicine/Primary Health Care, University of Gothenburg, Sweden.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Eva Lena Strandberg
Department of Clinical Sciences Malmö, Lund University, Sweden.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Christine Campbell
Usher Institute of Population Health Sciences and Medical Informatics, University of Edinburgh, UK.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joke C Korevaar
Sentinel Practices, NIVEL Primary Care Database, Utrecht, the Netherlands.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ranjan Parajuli
Department of Community Medicine, UiT The Arctic University of Norway, Norway.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info
  • eLetters
  • PDF
Loading

Abstract

Background Different abdominal symptoms may signal cancer, but their role is unclear.

Aim To examine associations between abdominal symptoms and subsequent cancer diagnosed in the abdominal region.

Design and setting Prospective cohort study comprising 493 GPs from surgeries in Norway, Denmark, Sweden, Scotland, Belgium, and the Netherlands.

Method Over a 10-day period, the GPs recorded consecutive consultations and noted: patients who presented with abdominal symptoms pre-specified on the registration form; additional data on non-specific symptoms; and features of the consultation. Eight months later, data on all cancer diagnoses among all study patients in the participating general practices were requested from the GPs.

Results Consultations with 61 802 patients were recorded and abdominal symptoms were documented in 6264 (10.1%) patients. Malignancy, both abdominal and non-abdominal, was subsequently diagnosed in 511 patients (0.8%). Among patients with a new cancer in the abdomen (n = 251), 175 (69.7%) were diagnosed within 180 days after consultation. In a multivariate model, the highest sex- and age-adjusted hazard ratio (HR) was for the single symptom of rectal bleeding (HR 19.1, 95% confidence interval = 8.7 to 41.7). Positive predictive values of >3% were found for macroscopic haematuria, rectal bleeding, and involuntary weight loss, with variations according to age and sex. The three symptoms relating to irregular bleeding had particularly high specificity in terms of colorectal, uterine, and bladder cancer.

Conclusions A patient with undiagnosed cancer may present with symptoms or no symptoms. Irregular bleeding must always be explained. Abdominal pain occurs with all types of abdominal cancer and several symptoms may signal colorectal cancer. The findings are important as they influence how GPs think and act, and how they can contribute to an earlier diagnosis of cancer.

  • cancer
  • early diagnosis
  • general practice
  • proportional hazard models
  • symptoms
  • Received July 6, 2017.
  • Revision requested August 3, 2017.
  • Accepted November 20, 2017.
  • © British Journal of General Practice 2018
View Full Text

  RCGP login

Members, please Login at RCGP to access the journal online.

  Subscriber login

Enter your BJGP login information below.

Log in using your username and password

Enter your British Journal of General Practice username.
Enter the password that accompanies your username.
Forgot your user name or password?

Log in through your institution

You may be able to gain access using your login credentials for your institution. Contact your library if you do not have a username and password.
If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Pay Per Article - You may access this article (from the computer you are currently using) for 1 day for US$35.00

Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.

  Subscribe

Subscribe to the Journal - Subscribe to the print and/or online journal.

Back to top
Previous ArticleNext Article

Online First

Download PDF
Download PowerPoint
Article Alerts
Or,
sign in or create an account with your email address
Email Article

Thank you for recommending British Journal of General Practice.

NOTE: We only request your email address so that the person to whom you are recommending the page knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Abdominal symptoms and cancer in the abdomen: prospective cohort study in European primary care
(Your Name) has forwarded a page to you from British Journal of General Practice
(Your Name) thought you would like to see this page from British Journal of General Practice.
Citation Tools
Abdominal symptoms and cancer in the abdomen: prospective cohort study in European primary care
Knut Holtedahl, Peter Hjertholm, Lars Borgquist, Gé A Donker, Frank Buntinx, David Weller, Tonje Braaten, Jörgen Månsson, Eva Lena Strandberg, Christine Campbell, Joke C Korevaar, Ranjan Parajuli
Br J Gen Pract 9 April 2018; bjgp18X695777. DOI: 10.3399/bjgp18X695777

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Abdominal symptoms and cancer in the abdomen: prospective cohort study in European primary care
Knut Holtedahl, Peter Hjertholm, Lars Borgquist, Gé A Donker, Frank Buntinx, David Weller, Tonje Braaten, Jörgen Månsson, Eva Lena Strandberg, Christine Campbell, Joke C Korevaar, Ranjan Parajuli
Br J Gen Pract 9 April 2018; bjgp18X695777. DOI: 10.3399/bjgp18X695777
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Mendeley logo Mendeley

Jump to section

  • Top
  • Article
    • Abstract
    • INTRODUCTION
    • METHOD
    • RESULTS
    • DISCUSSION
    • Acknowledgments
    • Notes
    • REFERENCES
  • Figures & Data
  • Info
  • eLetters
  • PDF

Keywords

  • cancer
  • early diagnosis
  • general practice
  • proportional hazard models
  • symptoms

More in this TOC Section

  • Development of a prediction tool for patients presenting with acute cough in primary care: a prognostic study spanning six European countries
  • Weight loss as a predictor of cancer in primary care: a systematic review and meta-analysis
Show more Research

Related Articles

Cited By...

 

BJGP Open

 

@BJGPjournal's Likes on Twitter

 
 

British Journal of General Practice

NAVIGATE

  • Home
  • Current Issue
  • All Issues
  • Online First
  • Authors & reviewers

RCGP

  • BJGP for RCGP members
  • BJGP Open
  • RCGP eLearning
  • InnovAiT Journal
  • Jobs and careers
  • RCGP e-Portfolio

MY ACCOUNT

  • RCGP members' login
  • Subscriber login
  • Activate subscription
  • Terms and conditions

NEWS AND UPDATES

  • About BJGP
  • Alerts
  • RSS feeds
  • Facebook
  • Twitter

AUTHORS & REVIEWERS

  • Submit an article
  • Writing for BJGP: research
  • Writing for BJGP: other sections
  • BJGP editorial process & policies
  • BJGP ethical guidelines
  • Peer review for BJGP

CUSTOMER SERVICES

  • Advertising
  • Contact subscription agent
  • Copyright
  • Librarian information

CONTRIBUTE

  • BJGP Blog
  • eLetters
  • Feedback

CONTACT US

BJGP Journal Office
RCGP
30 Euston Square
London NW1 2FB
Tel: +44(0) 20 3188 7400
Email: journal@rcgp.org.uk

British Journal of General Practice is an editorially-independent publication of the Royal College of General Practitioners
© 2018 British Journal of General Practice

Print ISSN: 0960-1643
Online ISSN: 1478-5242