Variety of Cancer Types Diagnosed Among Patients With Signs and Symptoms: A Large-Scale, Observational Study Using Claims Data

OBJECTIVES: Despite the availability of screenings in certain cancer types, the majority of cancers are diagnosed after patients present with signs and symptoms (SS). Almost half of the SS are non-specific and shared by multiple cancer types or non-cancer diseases, eg., gastrointestinal distress. This study sought to describe the cancer incidence rates and complexity of cancer types diagnosed after SS.

METHODS: This is a retrospective, observational study using the Pharmetrics ^Ⓡ Plus claims dataset. Patients aged 40+ newly presenting with any of 16 common SS (pain, abdominal pain, upper abdominal pain, dyspepsia, coughing, anemia, iron deficiency anemia, appetite loss, dysphagia, post menopausal bleeding, rectal bleeding, bloating, fatigue, change in bowel habit, weight loss, lung nodule) in 2021 without prior cancer diagnosis or diagnostic tests were included.

RESULTS: A total of 329,648 patients were identified (mean age, 60 years; male, 41.6%; commercial plan, 65%; Medicare Advantage, 35%). Within 6 months, 2.3% of patients developed cancers (12 months: 3.0%). Patients presenting with the same symptoms were diagnosed with a variety of cancer types. No single cancer type contributed more than 30% for all SS other than bleeding and lung nodule. Among patients with upper abdominal pain, 34 types of cancers were diagnosed by 6 months (37 by 12 months). Among patients with dyspepsia, 28 types of cancers were diagnosed by 6 months (32 by 12 months). For both symptoms, pancreatic cancer was the most common type diagnosed (12-16%).

CONCLUSIONS: Patients with SS experienced an elevated risk of cancer compared to the general population (1.11% aged 40+). Various cancer types were diagnosed within 6 and 12 months, with many cancer types sharing the same symptoms, which highlights the complexity in cancer diagnosis. Innovative tests that can better predict cancer risk and cancer types can improve the diagnostic workup efficiency.