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It’s fairly commonplace for primary care physicians to either refer or work up patients who present with symptoms that suggest cancer. British investigators assessed the risk for cancer associated with four such alarm symptoms — hematuria, dysphagia, hemoptysis, and rectal bleeding — using a large U.K. database from primary care practices.
Records were examined for 762,325 patients (age, ≥15 years) who were registered in the database between 1994 and 2000. Follow-up was limited to patients who had any of those four symptoms and no prior diagnosis of cancer. Each of the four symptoms was associated with a significantly increased risk for cancer diagnosis within the first 3 to 6 months of presenting with a symptom. The likelihood ratios for a …