Association between symptoms and new abdominal cancer for patients diagnosed with new abdominal cancer within 180 days after consultation, N = 61 337a
| Patients with cancer | Measures of association | Diagnostic probability (PPV) | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| All n = 175 | Male n= 95 | Female n= 80 | No cancer n= 61 162 | All LR | 95% CI | Male LR | Female LR | All sensitivity | 95% CI | All specificity | All PPV, % | 95% CI | Male PPV, % | Female PPV, % | ≤54 years PPV, % | 55–74 years PPV, % | ≥75 years PPV, % | |
| Abdominal symptoms | ||||||||||||||||||
| Abdominal pain, upper part | 31 | 15 | 16 | 2046 | 5.3 | 3.8 to 7.4 | 5.2 | 5.7 | 17.7 | 12.4 to 24.2 | 96.7 | 1.5 | 1.0 to 2.1 | 2.0 | 1.2 | 0.8 | 1.7 | 3.8 |
| Abdominal pain, lower part | 20 | 8 | 12 | 2084 | 3.4 | 2.2 to 5.1 | 3.1 | 3.9 | 11.4 | 7.1 to 17.1 | 96.6 | 1.0 | 0.6 to 1.5 | 1.2 | 0.8 | 0.3 | 1.4 | 2.3 |
| Constipation | 16 | 6 | 10 | 676 | 8.2 | 5.1 to 13.2 | 7.2 | 10.0 | 9.1 | 5.3 to 14.4 | 98.9 | 2.3 | 1.3 to 3.7 | 2.8 | 2.1 | 1.0 | 3.0 | 3.8 |
| Diarrhoea | 8 | 3 | 5 | 1103 | 2.5 | 1.3 to 5.0 | 1.7 | 3.5 | 4.6 | 2.0 to 8.8 | 98.2 | 0.7 | 0.3 to 1.4 | 0.7 | 0.7 | 0.7 | 0.3 | 1.7 |
| Distended abdomen, bloating | 17 | 8 | 9 | 1011 | 5.9 | 3.7 to 9.3 | 5.7 | 6.4 | 9.7 | 5.8 to 15.1 | 98.3 | 1.7 | 1.0 to 2.6 | 2.2 | 1.3 | 1.3 | 1.2 | 3.9 |
| Increased belching, flatulence | 9 | 5 | 4 | 489 | 6.4 | 3.4 to 12.2 | 7.1 | 6.0 | 5.1 | 2.4 to 9.5 | 99.2 | 1.8 | 0.8 to 3.4 | 2.8 | 1.3 | 2.4 | 1.1 | 1.4 |
| Acid regurgitation | 10 | 5 | 5 | 669 | 5.2 | 2.9 to 9.6 | 5.3 | 5.4 | 5.7 | 2.8 to 10.3 | 98.9 | 1.5 | 0.7 to 2.7 | 2.1 | 1.1 | 0.9 | 2.6 | 1.1 |
| Rectal bleeding | 15 | 4 | 11 | 385 | 13.6 | 8.3 to 22.3 | 6.8 | 21.6 | 8.6 | 4.9 to 13.7 | 99.4 | 3.8 | 2.1 to 6.0 | 2.7 | 4.4 | 2.1 | 4.5 | 6.8 |
| Unexpected genital bleeding | 3 | 0 | 3 | 195 | 5.4 | 1.7 to 16.7 | – | 7.7 | 1.7 | 0.4 to 4.9 | 99.7 | 1.5 | 0.3 to 4.4 | – | 1.6 | – | 8.1 | – |
| Macroscopic haematuria | 6 | 4 | 2 | 141 | 15.7 | 6.8 to 34.5 | 13.1 | 14.4 | 3.4 | 1.3 to 7.3 | 99.8 | 4.1 | 1.5 to 8.7 | 5.0 | 3.0 | – | 5.2 | 7.9 |
| Increased urinary frequency | 10 | 6 | 4 | 732 | 4.8 | 2.6 to 8.8 | 6.2 | 3.8 | 5.8 | 2.8 to 10.3 | 98.8 | 1.3 | 0.6 to 2.5 | 2.4 | 0.8 | – | 1.6 | 3.3 |
| Other abdominal problems | 18 | 9 | 9 | 1116 | 5.6 | 3.6 to 8.8 | 5.7 | 5.8 | 10.3 | 6.2 to 15.8 | 98.2 | 1.6 | 0.9 to 2.5 | 2.2 | 1.2 | 0.3 | 2.0 | 4.4 |
| 1 abdominal symptom only | 37 | 14 | 23 | 3354 | ||||||||||||||
| >1 abdominal symptom | 39 | 19 | 20 | 2748 | 5 | 3.8 to 6.6 | 5.2 | 5.1 | 22.3 | 16.4 to 29.2 | 95.5 | 1.4 | 1.0 to 1.9 | 2.0 | 1.1 | 0.6 | 1.9 | 3.1 |
| At least 1 abdominal symptom | 76 | 33 | 43 | 6102 | 4.4 | 3.7 to 5.2 | 3.9 | 5.1 | 43.4 | 36.0 to 51.1 | 90.0 | 1.2 | 1.0 to 1.5 | 1.5 | 1.1 | 0.3 | 1.6 | 3.2 |
| No symptom | 99 | 62 | 37 | 55060 | ||||||||||||||
| Non-specific symptoms when at least one abdominal symptom has been recorded | ||||||||||||||||||
| Lack of appetite | 18 | 6 | 12 | 853 | 7.4 | 4.7 to 11.5 | 4.8 | 10.4 | 10.3 | 6.2 to 15.8 | 98.6 | 2.1 | 1.2 to 3.2 | 1.9 | 2.2 | 0.9 | 2.9 | 3.7 |
| Unusual tiredness | 17 | 5 | 12 | 812 | 7.3 | 4.6 to 11.6 | 4.9 | 10.1 | 9.7 | 5.8 to 15.1 | 98.7 | 2.1 | 1.2 to 3.3 | 1.9 | 2.1 | 1.1 | 1.6 | 4.6 |
| Involuntary weight loss | 11 | 5 | 6 | 304 | 12.7 | 7.1 to 22.7 | 10.9 | 14.8 | 6.3 | 3.2 to 11.0 | 99.5 | 3.5 | 1.8 to 6.2 | 4.2 | 3.1 | 2.0 | 0.9 | 7.8 |
| >1 non-specific symptom | 13 | 4 | 9 | 381 | 11.6 | 6.8 to 19.7 | 7.4 | 17.1 | 7.4 | 4.0 to 12.4 | 99.4 | 3.3 | 1.8 to 5.6 | 2.9 | 3.5 | 2.0 | 1.7 | 6.6 |
| Any non-specific symptom | 29 | 10 | 19 | 1500 | 6.8 | 4.8 to 9.5 | 4.9 | 9.0 | 16.6 | 11.4 to 22.9 | 97.5 | 1.9 | 1.3 to 2.7 | 1.9 | 1.9 | 0.7 | 2.2 | 4.2 |
↵a Excluded from analyses in Tables 24 were: the remaining 336 patients with cancer in Table 1, and the 129 patients reported by GPs to have cancer but excluded as cancer patients for reasons given in Figure 1. LR = likelihood ratio. PPV = positive predictive value.