What symptoms spur cancer diagnoses

Cancer during adolescence is a scary thing, but it also doesn’t commonly occur in young patients. What are the symptoms that may spur an adolescent patient to speak to their clinician? A report in JAMA Network Open provides some answers.¹

The investigators run a cross-section analysis of the BRIGHTLIGHT cohort study. The study had been carried out at multiple hospitals in England. The participants were adolescents and young adults who were aged 12 to 24 years and who had cancer. Structured face-to-face interviews were used to find out information on 17 presenting symptoms that had been prespecified as well as the patient interval between the onset of the symptom and help seeking. The information collected from the interviews was linked to national cancer registry data.

There were 803 teenagers and young adults included in the study. Each participant had valid symptom information. The number of presenting symptoms was different among the cancer groups with most patients who had leukemia talking about multiple symptoms, but only 31% of melanoma patients indicating that they had multiple symptoms. Overall, there were 352 unique combinations of symptoms and the 10 most frequent combinations occurred in 304 patients.

Common symptoms found included:

• Lump or swelling: 419 patients (52%; 95% CI, 49%-56%)
• Extreme tiredness: 308 patients (38%; 95% CI, 35%-42%)
• Unexplained pain: 281 patients (35%; 95% CI, 32%-38%)
• Night sweats: 192 patients (24%; 95% CI, 21%-27%)
• Lymphadenopathy: 191 patients (24%; 95% CI, 21%-27%)
• Weight loss: 190 patients (24%; 95% CI, 21%-27%)

Additionally, 27% of the participants said that they had a patient interval longer than 1 month

The researchers concluded that there was a large number of presenting symptoms. Many of these symptoms were found in more than 1 cancer type group. Unfortunately, the variation in help-seeking was not big enough to make targeted awareness campaigns worthwhile.

Reference

1. Koo M, Lyratzopoulos G, Herbert A, et al. Association of self-reported presenting symptoms with timeliness of help-seeking among adolescents and young adults with cancer in the BRIGHTLIGHT study. JAMA Netw Open. 2020;3(9):e2015437. doi:10.1001/jamanetworkopen.2020.15437