BMJ  2007;334 (19 May), doi:10.1136/bmj.39218.433391.3A

Editor's Choice

US editor's choice

Alarming results

The first 150 words of the full text of this article appear below.

In the UK they are labelled "alarm symptoms," and in the US we call them "red flags": signs or symptoms in clinical care that are thought to predict serious disease and often lead to specialist referral. But what do we really know about the seriousness of dysphagia, hematuria, hemoptysis, or rectal bleeding? Not much, until now. Roger Jones and colleagues examined these symptoms and subsequent diagnoses in over 750,000 primary care patients, using the UK General Practice Research Database (doi: 10.1136/bmj.39171.637106.AE). They found that the new onset of alarm symptoms is associated with an increased likelihood of cancer, especially in men and the elderly. For example, 7.5% of men with new hemoptysis had a subsequent diagnosis of a respiratory tract cancer, many times the "background rate."

In a related editorial, Robin Fox and John Fletcher point out that new diagnoses of cancer are rare in primary care, on average . . . [Full text of this article]

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