Evidence map›Paper›PMID 29632004›Full record

SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2018

Weight loss as a predictor of cancer in primary care: a systematic review and meta-analysis.

Brian D Nicholson, William Hamilton, Jack O'Sullivan, Paul Aveyard, Fd Richard Hobbs

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 3 pooled it
3.7field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 3 syntheses or guidelines pooled it, 65 citations in OpenAlex.

  1. Pooled it
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  3. Weight loss as a predictor of cancer in primary care: a systematic review and meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018
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  7. Early-onset colorectal cancer: epidemiology, risk factors, and implications for clinical practice.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Brian D NicholsonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
William HamiltonMedical School, University of Exeter, Exeter.
Jack O'SullivanNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
Paul AveyardNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
Fd Richard HobbsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
University of Oxford · GBOxford Biomedical Research · USUniversity of Exeter · GB

Funding

Department of Health DRF-2015-08-185Department of Health IS-SPC-0514-10043
6 · The paper itself

Abstract

backgroundWeight loss is a non-specific cancer symptom for which there are no clinical guidelines about investigation in primary care.

aimTo summarise the available evidence on weight loss as a clinical feature of cancer in patients presenting to primary care. DESIGN AND

settingA diagnostic test accuracy review and meta-analysis.

methodStudies reporting 2 × 2 diagnostic accuracy data for weight loss (index test) in adults presenting to primary care and a subsequent diagnosis of cancer (reference standard) were included. QUADAS-2 was used to assess study quality. Sensitivity, specificity, positive likelihood ratios, and positive predictive values were calculated, and a bivariate meta-analysis performed.

resultsA total of 25 studies were included, with 23 (92%) using primary care records. Of these, 20 (80%) defined weight loss as a physician's coding of the symptom; the remainder collected data directly. One defined unexplained weight loss using objective measurements. Positive associations between weight loss and cancer were found for 10 cancer sites: prostate, colorectal, lung, gastro-oesophageal, pancreatic, non-Hodgkin's lymphoma, ovarian, myeloma, renal tract, and biliary tree. Sensitivity ranged from 2% to 47%, and specificity from 92% to 99%, across cancer sites. The positive predictive value for cancer in male and female patients with weight loss for all age groups ≥60 years exceeded the 3% risk threshold that current UK guidance proposes for further investigation.

conclusionA primary care clinician's decision to code for weight loss is highly predictive of cancer. For such patients, urgent referral pathways are justified to investigate for cancer across multiple sites.

Indexed as

Early Detection of CancerPrimary Health CareWeight LossColorectal NeoplasmsHumansPredictive Value of TestsReferral and Consultationcancerdiagnosisprimary caresystematic reviewweight loss

Identifiers

PMID29632004
PMCPMC5916078
OpenAlexW2788654991

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.