Involuntary weight loss without specific symptoms: a clinical prediction score for malignant neoplasm

Hernández, José L.; Matorras, P; Ja, Riancho; González‐Macías, Jesús

doi:10.1093/qjmed/hcg107

Cited by 31 publications

(25 citation statements)

References 11 publications

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“…Although weight loss among overweight and obese people has been shown to reduce blood pressure and blood glucose and improve lipid profile and insulin sensitivity (35, 36), unintentional weight loss has been linked to higher mortality risk (37) and can be a sign of many diseases including cancer (38)(39)(40). Furthermore, studies have shown that weight loss is associated with a decrease in the function aspects of the immune system (23, 41, 42).…”

Section: Discussionmentioning

confidence: 99%

Body Mass Index, Weight Change, and Survival in Non-Hodgkin Lymphoma Patients in Connecticut Women

Han

Stevens

Bradshaw

2013

Nutrition and Cancer

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Background Evidence is emerging that obesity and weight gain may affect the prognosis of several types of cancer. We investigated the impact of body mass index (BMI) as well as pre- and post-diagnosis weight changes on non-Hodgkin lymphoma (NHL) prognosis. Methods A cohort of 573 female incident NHL cases diagnosed during 1996–2000 in Connecticut was followed for a median of 7.8 years. Self-reported height and weight at three time points before and after diagnosis were collected. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using proportional hazard models adjusting for factors believed to be associated with overall survival of NHL. Results Underweight (BMI < 18.5; HR = 2.84; 95% CI = 1.12–7.15) before diagnosis was associated with poorer survival compared to being normal weight (18.5 <= BMI < 25). Pre-diagnosis weight loss (HR = 1.42; 95% CI = 1.02–1.97) and post-treatment weight loss (HR = 1.98; 95% CI = 1.14–3.45) and weight gain (HR = 1.85; 95% CI = 1.04–3.32) were associated with poorer survival. Conclusion NHL patients who were underweight, lost weight pre-diagnosis, or change weight after treatment were found to have a poorer survival.

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Section: Discussionmentioning

confidence: 99%

Body Mass Index, Weight Change, and Survival in Non-Hodgkin Lymphoma Patients in Connecticut Women

Han

Stevens

Bradshaw

2013

Nutrition and Cancer

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“…1,4,25,29 Patients with iron-deficiency anemia or symptoms likely to originate in the gastrointestinal tract, and patients with elevated liver enzyme levels on initial screening, should undergo investigation of their gastrointestinal tract (either endoscopy or upper gastrointestinal series) or an abdominal ultrasound, respectively. 1,4,24,29 Three scoring systems have been developed to help clinicians identify which patient with weight loss is likely to have a physical 1,4 or malignant 51 cause as opposed to a psychological or unknown cause. None of these scoring systems has been validated in independent populations presenting with weight loss.…”

Section: Optimal Clinical Approach To Weight Lossmentioning

confidence: 99%

An approach to the management of unintentional weight loss in elderly people

Alibhai

Greenwood²,

Payette³

2005

Canadian Medical Association Journal

231

143

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UNINTENTIONAL WEIGHT LOSS, or the involuntary decline in total body weight over time, is common among elderly people who live at home. Weight loss in elderly people can have a deleterious effect on the ability to function and on quality of life and is associated with an increase in mortality over a 12-month period. A variety of physical, psychological and social conditions, along with age-related changes, can lead to weight loss, but there may be no identifiable cause in up to one-quarter of patients. We review the incidence and prevalence of weight loss in elderly patients, its impact on morbidity and mortality, the common causes of unintentional weight loss and a clinical approach to diagnosis. Screening tools to detect malnutrition are highlighted, and nonpharmacologic and pharmacologic strategies to minimize or reverse weight loss in older adults are discussed.

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“…Other authors report that the cause for unintentional weight loss can be typically found through the patient's history, physical examination, and routine laboratory testing, with further studies performed as indicated. 1,4 Routine testing may include a complete blood count, complete metabolic panel, thyroid studies, C-reactive protein analgesia, and a chest radiograph for patients who smoke or who have respiratory symptoms. 3 This was a single-endoscopist case study, although the information was entered prospectively immediately after the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…One third of elderly patients with unintentional weight loss were diagnosed with malignancy. [1][2][3][4] Gastrointestinal malignancy is the most common type of occult malignancy diagnosed in patients with unintentional weight loss, and colorectal cancer (CRC) ranks third overall among the most common types of cancer in the United States. 5 In this study we examined the association between unintentional weight loss as a sole indication for colonoscopy and the risk for CRC.…”

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confidence: 99%

Unintentional Weight Loss as the Sole Indication for Colonoscopy is Rarely Associated with Colorectal Cancer

Davis¹,

Marek²,

Sridhar³

et al. 2011

The Journal of the American Board of Family Medicine

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Introduction: Weight loss is a commonly used indication for colonoscopy.Methods: This is a prospective case study of colonoscopies from 1998 to 2009. Descriptive statistics were used to evaluate age, sex, colonoscopy indications, and findings. Multiple logistic regression analysis was used to determine the odds of colorectal cancer (CRC) based on age, sex, and weight loss.Results: We reviewed 6425 colonoscopies. The mean age of patients was 57.4 years (SD, ؎13.5 years), and 55% of patients were women. One hundred thirty-six (2.1%) of these had unintentional weight loss; for 32 patients (0.4%), unintentional weight loss was the only indication for the procedure. CRC was diagnosed in 116 patients (1.8%), but CRC was not detected in any patients for whom unintentional weight loss as the only indication for colonoscopy.Conclusion: Based on our prospective case study, unintentional weight loss alone was not associated with CRC. (J Am Board Fam Med 2011;24:218 -219.)

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Involuntary weight loss without specific symptoms: a clinical prediction score for malignant neoplasm

Abstract: We believe this to be the first study to attempt a systematic approach to the diagnosis of isolated IWL. The approach, based on very simple clinical and laboratory data, should assist the physician in a rational approach to such patients.

Cited by 31 publications

References 11 publications

Body Mass Index, Weight Change, and Survival in Non-Hodgkin Lymphoma Patients in Connecticut Women

Body Mass Index, Weight Change, and Survival in Non-Hodgkin Lymphoma Patients in Connecticut Women

An approach to the management of unintentional weight loss in elderly people

Unintentional Weight Loss as the Sole Indication for Colonoscopy is Rarely Associated with Colorectal Cancer

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