ArticleUnited European gastroenterology journal2026
Later-Stage Diagnosis and Poorer Survival in Pancreatic Cancer Patients With Vague Symptoms: A Population-Based Study.
Article in United European gastroenterology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMost pancreatic cancer (PC) patients present symptomatically to cancer services, are diagnosed at late stage, and have poor survival. Patients with alarm symptoms (AS), such as jaundice or altered stool/urine colour, may be more readily recognised within current referral pathways than those with vague symptoms (VS).
objectiveTo examine the associations of presenting symptom category (alarm vs. vague) with route to diagnosis, stage at diagnosis, treatment, and survival in PC patients.
methodsOf 540 primary PC cases identified in the population-based Northern Ireland Cancer Registry PC Audit (2019-2020), 28 were excluded because referral pathway information was insufficient to classify route to diagnosis, leaving 512 patients for analysis. Patients were categorised by presenting symptoms as AS or VS. χ
resultsMore patients presented with VS (60.4%) than AS (39.6%). Emergency admission was more common in AS than in VS patients (66.0% vs. 33.7%, p < 0.001). VS patients more often had stage IV disease (62.1% vs. 39.9%, p < 0.001) and were less likely to receive tumour-reductive treatment (34.0% vs. 50.2%, p < 0.001). One-year survival was poorer in VS than in AS patients (24.9% vs. 33.7%, p = 0.001). VS was associated with a 48% increased mortality risk [HR = 1.48 (1.14-1.91)] after full adjustment.
conclusionPC patients with VS were more often presented via GP; they had later-stage disease and poorer survival. VS remained independently associated with poorer survival. Greater awareness of PC symptoms, especially VS, together with effective diagnostic pathways for non-specific symptoms, may help support more timely investigation.
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