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Sex- and age-specific 9-month cancer risk for each fatigue\u2013vague symptom cohort were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 285 382 patients presenting with new-onset fatigue, 84% (<jats:italic>n<\/jats:italic>= 239 846) did not have co-occurring alarm symptoms or anaemia. Of these, 38% (<jats:italic>n<\/jats:italic>= 90 828) presented with \u22651 of 19 vague symptoms for cancer. Cancer risk exceeded 3% in older males with fatigue combined with any of the vague symptoms studied. The age at which risk exceeded 3% was 59 years for fatigue\u2013weight loss, 65 years for fatigue\u2013abdominal pain, 67 years for fatigue\u2013constipation, and 67 years for fatigue\u2013other upper gastrointestinal symptoms. For females, risk exceeded 3% only in older patients with fatigue\u2013weight loss (from 65 years), fatigue\u2013abdominal pain (from 79 years), or fatigue\u2013abdominal bloating (from 80 years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the absence of alarm symptoms or anaemia, fatigue combined with specific vague presenting symptoms, alongside patient age and sex, can guide clinical decisions about referral for suspected cancer.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgp.2022.0371","type":"journal-article","created":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T01:20:12Z","timestamp":1667265612000},"page":"e75-e87","source":"Crossref","is-referenced-by-count":14,"title":["Underlying cancer risk among patients with fatigue and other vague symptoms: a population-based cohort study in primary care"],"prefix":"10.3399","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0643-7890","authenticated-orcid":false,"given":"Becky","family":"White","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3845-9493","authenticated-orcid":false,"given":"Cristina","family":"Renzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1148-1922","authenticated-orcid":false,"given":"Matthew","family":"Barclay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2873-7421","authenticated-orcid":false,"given":"Georgios","family":"Lyratzopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2022,10,31]]},"reference":[{"key":"2023032807550792000_73.727.e75.1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-14-636"},{"key":"2023032807550792000_73.727.e75.2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0127717"},{"issue":"1","key":"2023032807550792000_73.727.e75.3","doi-asserted-by":"crossref","first-page":"235","DOI":"10.14236\/jhi.v22i1.91","article-title":"Examining the symptom of fatigue in primary care: a comparative study using electronic medical records","volume":"22","author":"Nicholson","year":"2015","journal-title":"J Innov Heal Informatics"},{"issue":"7771","key":"2023032807550792000_73.727.e75.4","first-page":"502","article-title":"Rational testing: investigating fatigue in primary care","volume":"341","author":"Hamilton","year":"2010","journal-title":"BMJ"},{"key":"2023032807550792000_73.727.e75.5","doi-asserted-by":"publisher","DOI":"10.1007\/BF02598083"},{"key":"2023032807550792000_73.727.e75.6","doi-asserted-by":"publisher","DOI":"10.1007\/BF03168931"},{"key":"2023032807550792000_73.727.e75.7","doi-asserted-by":"publisher","DOI":"10.1258\/jrsm.97.12.571"},{"issue":"6","key":"2023032807550792000_73.727.e75.8","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1503\/cmaj.1031153","article-title":"Fatigue: a practical approach to diagnosis in primary care","volume":"174","author":"Cornuz","year":"2006","journal-title":"CMAJ"},{"key":"2023032807550792000_73.727.e75.9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.325.7362.480"},{"issue":"1","key":"2023032807550792000_73.727.e75.10","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1186\/s12875-016-0545-5","article-title":"The differential diagnosis of tiredness: a systematic review","volume":"17","author":"Stadje","year":"2016","journal-title":"BMC Fam Pract"},{"key":"2023032807550792000_73.727.e75.11","unstructured":"National Institute for Health and Care Excellence (2011) The recognition and initial management of ovarian cancer: evidence review, https:\/\/www.nice.org.uk\/guidance\/cg122\/evidence\/evidence-review-pdf-181688798 (accessed 27 Oct 2022)."},{"key":"2023032807550792000_73.727.e75.12","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30595-9"},{"issue":"2","key":"2023032807550792000_73.727.e75.13","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.neo.2017.11.005","article-title":"Symptom signatures and diagnostic timeliness in cancer patients: a review of current evidence","volume":"20","author":"Koo","year":"2018","journal-title":"Neoplasia (United States)"},{"key":"2023032807550792000_73.727.e75.14","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmi044"},{"key":"2023032807550792000_73.727.e75.15","doi-asserted-by":"crossref","unstructured":"Dommett RM Redaniel T Stevens MC (2013) Risk of childhood cancer with symptoms in primary care: a population-based case-control study. 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