Cancer is one of the four most likely conditions for clinicians to consider in older men who go to their GP with new-onset fatigue, a study led by UCL researchers has found.
For the study, published in the British Journal of General Practice (BJGP), researchers analysed the health records of more than a quarter of a million people in England whose doctor noted that they were tired.
The team looked at how common 237 diseases were in the year after patients visited their GP, comparing patients who reported tiredness with those who did not.
They found that cancer had the fourth highest excess risk in men aged 80 with fatigue compared with men without fatigue, but was only 13th highest in women of the same age.
Researchers said doctors should consider investigating cancer in men aged 70 and over who complain of tiredness, "but not in women at any age, if based solely on the presence of fatigue".
Lead author Dr Becky White (UCL Institute of Epidemiology & Health Care) said: "Tiredness is a common symptom that many people go to their doctor about at some point in their lives, and it can be hard for doctors to know which conditions to suspect. Although it’s very rare, sometimes it can be caused by life-threatening diseases like cancer.
"This is the first time we have comprehensively studied which diseases people are diagnosed with shortly after they first report being tired to their doctor.
"We found that cancer was one of the top four diseases to consider in older men with tiredness, but not in women. Since we can now rank which diseases are most likely, we can help GPs decide which diseases to investigate first and what else to ask the patient about."
The study also found that other conditions like depression, respiratory tract infections, and sleep disorders were among the conditions most strongly associated with tiredness, as well as (among women only) an over-active and under-active thyroid. These links depended strongly on the patient’s sex and age.
The comprehensive study aims to improve diagnostic guidelines by showing GPs which diseases to prioritise testing for when patients first report feeling tired, based on their age and sex.
Claire Knight, senior health information manager at Cancer Research UK, said: "There are over 200 types of cancer with lots of different possible symptoms and it’s impossible to know them all. Like fatigue, some symptoms can be general and aren’t specific to an area of the body.
"You know your body best, so it’s important to get your doctor’s advice if you notice anything that’s not normal for you or isn’t going away. Don’t ignore it or put it down to ’just getting older’.
"It probably won’t be cancer. But if it is, spotting it at an early stage means that treatment is more likely to be successful."
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