Aims:-
CT Chest, Abdomen and Pelvis (CT-CAP) is frequently used as a screening tool to identify malignant causes of unintentional weight loss. Despite this, the rate of detecting malignancy varies widely between studies, 4.5% to 28%. This could be due to the average age of participants, degree or duration of weight loss. This audit aims to report the prevalence of radiologically suspected malignant causes of unintentional weight loss in older patients in a New Zealand Hospital and explore if age, degree of weight loss influences rate of positive malignant findings.
Methods:-
Retrospective study of patients aged ³65 years referred to radiology department for CT-CAP for unintentional or unexplained weight loss between 01/07/2020 to 01/04/2021. Malignancy or possible malignancy is determined by the formal radiology report. Malignancy type is divided into breast, gastrointestinal, haematological, lung, urological and others. Age, weight loss, duration of weight loss(months), and current body weight will be acquired from the notes. Student T-test is used to compare mean age, weight loss, weight loss/month, and percentage weight loss(weight loss/current weight+weight loss ) with malignancy versus no malignancy to determine if any factor is more predictive for a positive cancer finding.
Results:-
Of the 1327 CT-CAP done in the study period, 130 met inclusion criteria. Average age of the participants were 78.7±7.8 years with 55% being females. The average reported weight loss was 10.8±7.2kg(n=104) with the average reported months being 6.3±4.4(n=105). Average current weight was 63.7± 16.5kg(n=52). 32.3% of participants were found to have malignancy or possible malignancy, of which gastrointestinal causes was the most common. Age, weight loss, weight loss/month and percentage weight loss were not associated with risk of malignancy.
Discussion:-
Findings of radiologically suspected malignancy is common amongst older participants with weight loss. However neither age, weight loss, weight loss/month and percentage weight loss were associated with risk being detected to have malignancy. For percentage weight loss, this could be due to the small available sample size (n=48 ). Accuracy of reported weight loss could also be another factor. Further studies with more accurately reported weight loss and more measurement of current weight would help answer this question.