Patient-centered Weight Tracking as an Early Cancer Detection Strategy

Abstract

Unintentional weight loss (UWL) is typically defined as a decrease from baseline body weight of greater than five percent within a six-to twelve-month period [1]. Several retrospective studies have estimated the incidence of UWL in the general population to be somewhere between 1% to 7% per year in adults who are 60 to 80 years old [2-9]. There is a wide range of possible causes for UWL, such as depression, functional decline in diverse organ systems, and gastrointestinal diseases. The most commonly described etiology, occult malignancy, is responsible for roughly 20% of all UWL cases [1-9]. UWL has been reported in a diverse range of malignancies, including colon, lung, prostate, pancreatic, and gastric cancer [10-15]. Despite these facts, it is unclear why UWL has largely been overlooked as a potential pan-cancer biomarker. To highlight this point, a previous report demonstrated that weight loss was unrecognized by clinicians in 60% of cases, and 27% of those patients with weight loss were subsequently diagnosed with a malignancy [16]. While there has been progress in cancer treatment, cancer still ranks as the second-most common cause of death in the United States, with over 600,000 cancer-related deaths annually [17,18]. One in five patients in this country are expected to ultimately die from cancer [19]. In the year 2020 alone, 1,800,000 cancers will be diagnosed in the United States [17-19]. Approximately one in every two males and one in three females will be diagnosed with some forms of malignancy in their lifetime [17,19,20]. Cancer is challenging to treat successfully when it presents at an advanced stage. Early cancer detection, therefore, is critical to improve prognosis. Despite the fact that over $6 billion dollars is spent annually on cancer research by the National Cancer Institute, only 10% is allocated to early de