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Investigate all unexplained jaundice cases, experts say

GPs should investigate all unexplained cases of jaundice as it is the best predictor for the development of a pancreatic tumour, say UK researchers.

The study looked at 3,635 cases of pancreatic tumours in the UK population from 2000-2009 in patients aged 40 years or over.

They identified the common features of pancreatic cancer that patients presented with, and found jaundice was present in 30% of patients with tumours, and had the highest positive predictive value at 12.9%. By comparison, the next highest was weight loss at 0.44%.

When conducting further analysis on the findings, they found patients with jaundice had an odds ratio of 1,000 of developing pancreatic cancer, compared with an odds ratio of 12 for weight loss.

Study lead Professor Willie Hamilton, professor of primary care diagnostics at the University of Exeter, said: ‘Current NICE guidance recommends urgent referral only for obstructive jaundice, but the results from this study would suggest that investigation for jaundice per se is warranted, unless there is a clear alternative cause.'


British Journal of Cancer 2012, online 22 May


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