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Symptom Signatures and Diagnostic Timeliness in Cancer Patients: A Review of Current Evidence

Lookup NU author(s): Emeritus Professor Greg RubinORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2017 The Authors Early diagnosis is an important aspect of contemporary cancer prevention and control strategies, as the majority of patients are diagnosed following symptomatic presentation. The nature of presenting symptoms can critically influence the length of the diagnostic intervals from symptom onset to presentation (the patient interval), and from first presentation to specialist referral (the primary care interval). Understanding which symptoms are associated with longer diagnostic intervals to help the targeting of early diagnosis initiatives is an area of emerging research. In this Review, we consider the methodological challenges in studying the presenting symptoms and intervals to diagnosis of cancer patients, and summarize current evidence on presenting symptoms associated with a range of common and rarer cancer sites. We propose a taxonomy of cancer sites considering their symptom signature and the predictive value of common presenting symptoms. Finally, we consider evidence on associations between symptomatic presentations and intervals to diagnosis before discussing implications for the design, implementation, and evaluation of public health or health system interventions to achieve the earlier detection of cancer.

Publication metadata

Author(s): Koo MM, Hamilton W, Walter FM, Rubin GP, Lyratzopoulos G

Publication type: Review

Publication status: Published

Journal: Neoplasia

Year: 2018

Volume: 20

Issue: 2

Pages: 165-174

Print publication date: 01/02/2018

Online publication date: 16/12/2017

Acceptance date: 13/11/2017

ISSN (print): 1522-8002

ISSN (electronic): 1476-5586

Publisher: Neoplasia Press, Inc.


DOI: 10.1016/j.neo.2017.11.005