{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T11:04:55Z","timestamp":1784199895315,"version":"3.55.0"},"reference-count":67,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pancreatic cancer has a high mortality rate due to late diagnosis and presentation with non\u2010specific symptoms like weight loss. Quantifying weight loss more precisely could enhance its utility as a diagnostic marker.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In March 2025, we systematically searched PubMed, Embase, Web of Science, The Cochrane Library, and Scopus for studies reporting quantitative pre\u2010diagnosis weight loss in pancreatic cancer, with no date restrictions. The protocol was registered with PROSPERO (CRD42022302985). Primary outcomes were weight loss (kg) and BMI change (kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). Meta\u2010analyses provided pooled estimates with 95% confidence intervals, displayed in forest plots. We conducted stratified analyses at the study level by diabetes status, cancer type, self\u2010reported weight change, and timing of weight loss. Subgroup analyses considered publication year, country, study design, mean age, and percentage of male participants. Study quality and bias were assessed using the ROBINS\u2010I framework.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The analysis included 25 studies (25,971 participants). In random\u2010effects meta\u2010analysis, we found that on average participants lost 5.9\u2009kg [95% CI 4.7 to 7.1] of body weight. The average BMI change was \u22122.5\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      [95% CI \u22123.0 to \u22122.1]. There was significant heterogeneity between studies for both weight loss (I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200999.2%) and BMI change (I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200982.6%). For weight loss in kg, heterogeneity was partially explained (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) by diabetes status (0.15%), weight loss timing (15.5%), whether weight loss was self\u2010reported (11.4%) and publication year (13.1%). For BMI change heterogeneity was partially explained (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) by pancreatic cancer type (1.3%), whether BMI change was self\u2010reported (49.6%) and publication year (49.5%). Post hoc pairwise comparisons of moderators for stratified analysis were not significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0125). The certainty of evidence was moderate due to high heterogeneity between studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This meta\u2010analysis provides a reference for expected weight loss in pancreatic cancer, aiding clinical practice and improving early detection models.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71997","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T03:41:00Z","timestamp":1780285260000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantifying Weight Loss Prior to Pancreatic Cancer Diagnosis: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3060-9821","authenticated-orcid":false,"given":"Claire A.","family":"Price","sequence":"first","affiliation":[{"name":"University of Surrey, School of Health Sciences  Surrey UK"},{"name":"National Physical Laboratory  Middlesex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie","family":"Cooke","sequence":"additional","affiliation":[{"name":"University of Surrey, School of Health Sciences  Surrey UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freda","family":"Mold","sequence":"additional","affiliation":[{"name":"University of Surrey, School of Health Sciences  Surrey UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia A. S.","family":"Smith","sequence":"additional","affiliation":[{"name":"Royal Surrey NHS Foundation Trust, Scientific Computing  Guildford UK"},{"name":"T\u00dcV S\u00dcD UK, Chadwick House  Warrington UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martyn","family":"Winn","sequence":"additional","affiliation":[{"name":"Science and Technology Facilities Council, Scientific Computing Department, Research Complex at Harwell  Didcot UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Lemanska","sequence":"additional","affiliation":[{"name":"Imperial Clinical Trials Unit, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,31]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-14-0155"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-0542"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)33326-3"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_2_11_6_1","unstructured":"Cancer Research UK Cancer mortality for common cancers 2015accessed at January 19 2023 https:\/\/www.cancerresearchuk.org\/health\u2010professional\/cancer\u2010statistics\/mortality\/common\u2010cancers\u2010compared."},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2016.304"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdz051"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(18)30267-6"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2016.1197419"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2025.01.014"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(19)30416-9"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2009.236"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-006-9131-8"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70337-1"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.14740\/wjon1166"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2018.09.012"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000000701"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.6092\/1590\u20108577\/2778"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0000000000000663"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.4149\/neo_2020_200706N699"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2021.0153"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-021-09861-8"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.01.039"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0275369"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.07.046"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-004215"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.253"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000002052"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp12X616355"},{"key":"e_1_2_11_32_1","unstructured":"NICE Suspected Cancer: Recognition and Referral. 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