Langue Gladys, Pinker India, Moran Valerie, Pilleron Sophie
Ageing, Cancer and Disparities Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg.
Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg.
PLoS One. 2025 Jun 23;20(6):e0322264. doi: 10.1371/journal.pone.0322264. eCollection 2025.
Non-specific cancer symptoms are challenging to interpret in general practice. They can be attributed to a wide range of other conditions and delay the cancer diagnosis, increasing the risk of poor outcomes.
To summarise existing knowledge on the attribution of non-specific symptoms to potential cancer in general practice and identify gaps in the literature.
We conducted a scoping review, following Joanna Briggs Institute's guidance and reported according to the PRISMA for scoping reviews checklist. Non-specific symptoms were defined based on NICE guidelines for suspected cancer. We systematically searched six databases and search engines for original papers, systematic reviews and doctoral theses. Two reviewers independently screened titles, abstracts, full-texts and reference lists. Included articles were then uploaded to the AI-based tool ResearchRabbit to identify further papers. Findings were synthesised using the Refined Andersen Model of Total Patient Delay.
Eight studies were included. These addressed fatigue, recurrent infection, pallor, weight loss, and deep vein thrombosis, with general practitioners (GPs) defining the latter two as cancer-specific. Factors influencing attribution to cancer included pre-existing conditions, the number, type and combination of symptoms as well as GPs' gut feeling and knowledge, patients' concern, and the frequency of medical visits.
This scoping review identified a limited number of studies on the attribution of non-specific symptoms to potential cancer in general practice, with symptoms such as pruritus and new-onset diabetes not addressed. It highlights the need for further research into GPs diagnostic reasoning related to non-specific cancer symptoms, especially on under-researched symptoms.
在全科医疗中，非特异性癌症症状难以解读。它们可能归因于多种其他病症，会延误癌症诊断，增加不良结局的风险。
总结全科医疗中关于将非特异性症状归因于潜在癌症的现有知识，并找出文献中的空白。
我们按照乔安娜·布里格斯研究所的指导进行了一项范围综述，并根据PRISMA范围综述清单进行报告。非特异性症状根据英国国家卫生与临床优化研究所（NICE）关于疑似癌症的指南来定义。我们系统地检索了六个数据库和搜索引擎，以查找原创论文、系统综述和博士论文。两名评审员独立筛选标题、摘要、全文和参考文献列表。然后将纳入的文章上传到基于人工智能的工具ResearchRabbit，以识别更多论文。研究结果使用改进的安德森全患者延迟模型进行综合分析。
纳入了八项研究。这些研究涉及疲劳、反复感染、面色苍白、体重减轻和深静脉血栓形成，全科医生（GP）将后两者定义为癌症特异性症状。影响归因于癌症的因素包括既往病症、症状的数量、类型和组合，以及全科医生的直觉和知识、患者的担忧和就诊频率。
这项范围综述发现，关于全科医疗中把非特异性症状归因于潜在癌症的研究数量有限，瘙痒和新发糖尿病等症状未被涉及。它强调需要进一步研究全科医生与非特异性癌症症状相关的诊断推理，尤其是对研究不足的症状。
