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Researchers have identified a series of symptoms associated with pancreatic cancer, including two previously unrecognised symptoms, in the largest study of its kind.

Pancreatic Cancer highlighted in the body

Today,  research presented by Dr Weiqi Liao of the Nuffield Department of Primary Care Health Sciences has confirmed a further 21 signs of pancreatic cancer. This includes two previously unrecognised symptoms – feeling thirsty and having dark urine. The study has shown that patients often have some symptoms of the disease up to a year before their cancers are diagnosed, and other alarming symptoms three months before diagnosis. 

Pancreatic cancer has the lowest survival among all common cancers, with five-year survival around 7% in the UK. Unfortunately, most people with pancreatic cancer are diagnosed at a late stage. Researchers want to better understand the early signs of pancreatic cancer because if patients and GPs are more aware of symptoms, they could be diagnosed earlier when their chance of survival is better.

The researchers hope their findings could improve survival by helping GPs diagnose the disease earlier, especially when patients present with several seemingly non-specific symptoms.


When pancreatic cancer is diagnosed earlier, patients have a higher chance of survival. It is possible to diagnose patients when they visit their GP, but both patients and GPs need to be aware of the symptoms associated with pancreatic cancer - Dr Weiqi Liao

Led by Professor Julia Hippisley-Cox, the study looked at data from 24,236 patients who were diagnosed with pancreatic cancer in England between 2000 and 2017 using a large electronic database (QResearch). The researchers looked at patients’ symptoms at different time points before they were diagnosed with cancer and compared them to other patients’ symptoms who were not diagnosed with pancreatic cancer.

The research, which is the largest study of its kind, found 23 symptoms linked with the diagnosis of PDAC (yellowing of the skin, bleeding in the stomach or intestine, problems swallowing, diarrhoea, change in bowel habits, vomiting, indigestion, abdominal mass, abdominal pain, weight loss, constipation, fat in stool, abdominal swelling, nausea, flatulence, heartburn, fever, tiredness, appetite loss, itching, back pain, thirst, and dark urine). Nine symptoms were linked with PNEN (yellowing of the skin, blood in stool, diarrhoea, change in bowel habits, vomiting, indigestion, abdominal mass, abdominal pain, and weight loss).

While most symptoms were not specific to pancreatic cancer and could be due to other benign conditions, the researchers found patients diagnosed with pancreatic cancer had a higher chance of experiencing some of these non-specific symptoms one year before diagnosis.


These new findings enable us to conduct further work on understanding symptoms that could suggest pancreatic cancer. This will help GPs to make decisions about who to refer for urgent tests, especially when patients have several seemingly non-specific symptoms. - Dr Weiqi Liao


We thank the many hundreds of GPs using EMIS – an electronic patient record system widely used in the UK – who contribute anonymised data to the QResearch database, without whom this novel research in such a rare but important condition, would not have been possible.
- Professor Julia Hippisley-Cox

These results could now be used to update QCancer, a risk prediction model that has been created from the QResearch database to help GPs identify high-risk patients for further tests to diagnose cancer.

University of Oxford researchers are presenting their work at the NCRI Festival this week. The NCRI Festival is running as a virtual event in place of this year’s NCRI Cancer Conference in response to the COVID-19 pandemic. It is taking place from 8 to 12 November 2021. For more information visit

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