Results from multivariable logistic regression models outlining the frequency and adjusted ORs of symptoms and signs of pancreatic cancer and BTC presenting to primary care in the 2 years prior to diagnosis compared with a control population without a cancer diagnosis
| Biliary tract cancer | Pancreatic cancer | Controls | Pancreatic cancer vs control | Biliary tract cancer vs control | Pancreatic cancer vs biliary tract cancer | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptom (%) | n=829 | n=2790 | n=17 192 | OR* | 95% CI | p Value | OR* | 95% CI | p Value | OR* | 95% CI | p Value |
| Weight loss | 46 (5.5) | 294 (10.5) | 302 (1.8) | 6.6 | 5.54 to 7.86 | <0.001 | 3.17 | 2.32 to 4.34 | <0.001 | 2.00 | 1.49 to 2.68 | <0.001 |
| Abdominal pain | 309 (37.3) | 1225 (43.9) | 1946 (11.3) | 6.38 | 5.81 to 7.02 | <0.001 | 4.68 | 4.01 to 5.47 | <0.001 | 1.35 | 1.15 to 159 | <0.001 |
| Nausea and vomiting | 126 (15.2) | 463 (16.6) | 978 (5.7) | 3.43 | 3.00 to 3.91 | <0.001 | 2.99 | 2.44 to 3.66 | <0.001 | 1.12 | 0.89 to 1.39 | 0.33 |
| Bloating | 27 (3.3) | 113 (4.1) | 229 (1.3) | 3.1 | 2.48 to 3.89 | <0.001 | 2.35 | 1.57 to 3.53 | <0.001 | 1.25 | 0.82 to 1.89 | 0.298 |
| Dyspepsia | 118 (14.2) | 559 (20) | 1597 (9.3) | 2.56 | 2.30 to 2.85 | <0.001 | 1.7 | 1.40 to 2.08 | <0.001 | 1.51 | 1.23 to 1.86 | <0.001 |
| New onset diabetes | 48 (5.8) | 380 (13.6) | 1037 (6) | 2.46 | 2.16 to 2.80 | <0.001 | 0.92 | 0.68 to 1.23 | 0.559 | 2.59 | 1.91 to 3.52 | <0.001 |
| Change in bowel habit | 194 (23.4) | 764 (27.4) | 2557 (14.9) | 2.17 | 1.98 to 2.39 | <0.001 | 1.77 | 1.51 to 2.09 | <0.001 | 1.23 | 1.04 to 1.46 | 0.014 |
| Pruritus | 91 (11) | 147 (5.3) | 526 (3.1) | 1.73 | 1.43 to 2.10 | <0.001 | 3.75 | 2.96 to 4.74 | <0.001 | 0.44 | 0.34 to 0.59 | <0.001 |
| Lethargy | 71 (8.6) | 293 (10.5) | 1308 (7.6) | 1.42 | 1.25 to 1.61 | <0.001 | 1.08 | 0.83 to 1.40 | 0.57 | 1.28 | 0.97 to 1.68 | 0.086 |
| Back pain | 111 (13.4) | 446 (16) | 2111 (12.3) | 1.33 | 1.18 to 1.49 | <0.001 | 1.01 | 0.82 to 1.26 | 0.913 | 1.28 | 1.01 to 1.61 | 0.037 |
| Dysphagia | 10 (1.2) | 51 (1.8) | 254 (1.5) | 1.21 | 0.90 to 1.64 | 0.206 | 0.81 | 0.43 to 1.51 | 0.498 | 1.51 | 0.76 to 3.03 | 0.241 |
| Non-cardiac chest pain | 114 (13.8) | 335 (12) | 2055 (12) | 1.02 | 0.91 to 1.16 | 0.699 | 1.19 | 0.97 to 1.46 | 0.092 | 0.86 | 0.70 to 1.07 | 0.175 |
| Shoulder pain | 47 (5.7) | 137 (4.9) | 1052 (6.1) | 0.78 | 0.65 to 0.93 | 0.006 | 0.86 | 0.64 to 1.14 | 0.294 | 0.87 | 0.63 to 1.18 | 0.367 |
| Jaundice * | 358 (43.2) | 860 (30.8) | 36 (0.2) | 246.00 | 172 to 351 | <0.001 | 445 | 302 to 658 | <0.001 | 0.57 | 0.48 to 0.66 | <0.001 |
Models were adjusted for age, gender, time period and social deprivation (each symptom was assessed independently).
*Only 0.2% of controls were recorded with jaundice. However, among patients with PDAC and BCT, jaundice was highly prevalent occurring in 43.2% of patients with BTC and 30.8% of patients with PDAC which lead to extremely large OR estimates.
BTC, biliary tract cancer; PDAC, pancreatic ductal adenocarcinoma.