When Should Patients with Unexpected Weight Loss Undergo Intensive Workups for Cancer?

In primary care patients, a finding of unexpected weight loss (UWL) raises the likelihood of a cancer diagnosis in the next 6 months, but other explanations of UWL are possible. Intensive investigation of these patients usually fails to identify malignancy. U.K. guidelines suggest intensive investigation only when cancer risk exceeds 3%.

To determine what clinical findings, in combination with UWL, would raise risk to that level, researchers in the U.K. identified ≈64,000 adult patients with diagnoses of UWL and no record of prior malignancy or medical or surgical treatment for weight reduction. Among these patients, risk for a cancer diagnosis within 6 months after the first observation of UWL was greater than 3% in older men (age, ≥60) and…